Introduction: Cardiac resynchronization therapy (CRT) is worldwide accepted therapy for refractory heart failure with NYHA functional class II-IV; however almost all the studies that support this evidence had the right lead in apex instead the outflow tract. The aim of this study is to show our results in a long term follow up in CRT with the right lead in the right ventricular outflow tract (RVOT) instead of right apex.
Patients and methods: We prospectively included all patients referred to our center for CRT; since 1999 to January 2012. We evaluated them before and after the device implantation and in the follow up; with clinical test like functional class and objective test such as 6 minute walking, stress testing with Naughton protocol and with several echocardiographic parameters. We used central tendency meters and T pair test for the statistical analyses.
Results: A total of 72 patients (pts) were suitable for inclusion. There were 49 (68%) male pts with a median age of 56 ± 10 years. The dilated pathology was due to ischemic cardiopathy in 37(51%). The co-morbilities were hypertension in 31 (43%), dyslipidemia in 22(30%), smokers in 17 (23%) diabetes in 13 (18%) and Atrial fibrillation in 10 (14%). With CRT 56 (78%) of which 11(15%) had simultaneous V-V pacing (“Y” connection) and with CRT/D 16(22%). The median follow up was 34 months (rank 12-144 months).
Conclusions: As far as we know this is the first long term report of CRT with right ventricular lead in RVOT, without complications and with a good objective response in the stress testing and echocardiographic parameters and in the clinical evaluation such as NYHA class. This lead position could be a better option for the right ventricle pacing.