Regular paperEffectiveness of resynchronization therapy in patients with end-stage heart failure
Section snippets
Patients:
The traditional inclusion criteria for biventricular pacing were applied1: end-stage heart failure, New York Heart Assocation (NYHA) functional class III or IV, LV ejection fraction (EF) <35%, QRS duration >120 ms, or >200 ms for paced QRS (in patients with a previous pacemaker), and left bundle branch block morphology. Consecutive patients with ischemic and nonischemic etiology were included; etiology of heart failure was assessed by left- and right-sided heart catheterization and coronary
Patient population
Forty patients were included (31 men, mean age 64 ± 10 years). The mean NYHA class was 3.3 ± 0.5. According to the inclusion criteria, all patients had severe LV dysfunction, with a mean LVEF of 24 ± 9% (range 11% to 35%). Nineteen patients (48%) had heart failure of ischemic etiology and 21 (53%) of nonischemic etiology. Mean QRS duration on surface electrocardiogram ranged from 120 to 240 ms.
Pacemaker implantation
Eleven patients had previously undergone pacemaker implantation for conventional indications for
Discussion
Biventricular pacing in 40 patients with end-stage heart failure resulted in an improvement in symptoms (NYHA class) and quality of life, accompanied by improvement in more objective parameters including 6-minute walking distance and LVEF. These effects were observed at early follow-up (3 months after implantation) and were maintained at 6-month follow-up. In addition, annual hospitalization rates for heart failure decreased significantly after pacemaker implantation and excellent long-term
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