Clinical Outcomes of Cardiac Resynchronization with Epicardial Left Ventricular Lead

Abstract

In this case-matched two-centered study, comparable improvements were noted in patients with tLV-CRT and eLV-CRT. Operators should target nonanterior and nonapical locations during eLV-CRT implantation. Use of eLV-CRT should be considered a viable alternative for CRT candidates.

Fracture of an epicardial left ventricular lead implanted at open‐heart surgery in anticipation of future need for cardiac resynchronization therapy

“…Two randomized trials with only 9 and 22 surgically placed epicardial leads did not show any difference in clinical CRT response evaluated by left ventricular remodeling, NYHA functional class and 6‐minute walk test. Three small retrospective studies have demonstrated equivalent findings . Overall, limited clinical data suggest that patients with epicardial and endocardial LV leads have comparable clinical response to CRT.…”

“…Three small retrospective studies have demonstrated equivalent findings. 3,4,9 Overall, limited clinical data suggest that patients with epicardial and endocardial LV leads have comparable clinical response to CRT.…”

“…Transvenous implantation of a left ventricular (LV) lead via the coronary sinus can be achieved in >90% of patients . Alternatively, a transthoracic epicardial LV lead can be deployed in cases of failed transvenous implantation or de novo at the time of open‐heart surgery if a future need for CRT is considered likely . However, outcome data on transthoracic epicardial LV leads and modes of failure are sparse.…”

Dramatic improvement of left ventricular function after switching the ventricular pacing site from the right ventricular apex to the left ventricular free wall via a left mini thoracotomy: a case report

“…There have been only a few studies of the effect of the LV lead alone, because it is normally implanted surgically, and, therefore, very unusual as a routine pacing site. Chen et al reported that using an epicardial LV lead at CRT implantation was equivalent to a coronary sinus approach [3]. Shan et al reported using an epicardial LV lead for prophylactic use during open heart surgery in patients with low cardiac function likely to require CRT implantation after operation [4].…”

Avaliação dos super-respondedores à terapia de ressincronização cardíaca na presença de bloqueio de ramo esquerdo e ausência de fibrose na parede póstero-lateral do ventrículo esquerdo

“…A literatura atual aprova essas duas técnicas, bem como relata resultados semelhantes na taxa de resposta à ressincronização, estando essa última técnica associada a um período de internação ligeiramente superior. 88 As marcas dos dispositivos utilizados no implante foram as quatro disponibilizadas pela ANVISA no mercado brasileiro. Foram usados materiais das empresas Biotronik, Boston, Medtronic e Saint Jude.…”