Introduction: Epicardial left ventricle lead (ELVL) is an alternative when a coronary sinus lead (CSL) implantation failed. The aim of the study was to assess the outcome of both approaches.
Methods: A prospective analysis was performed in 97 pts with idiopathic dilated or ischemic cardiomyopathy who fulfilled CRT-D indications. Group A: 22 pts underwent surgical implantation of ELVL. Group B: 75 pts received CSL implantation. Mean follow up: 21 months (2-69).
Pts were considered responders if there was a LVEF improvement ?5% and/or a reduction of ?1 NYHA functional class. Responder rate, mean LVEF improvement and end diastolic left ventricle diameter (EDLVD) were assessed.
Results: Baseline characteristics were similar in both groups. Responder rate was 86% vs 70.6% (ns), mean LVEF improvement was 11.5±10% vs 10.7±10% (ns) and EDLVD reduction was 11±13% vs 5.6±12.8% (ns) among group A and B respectively.
Conclusions: In our study population ELVL implantation was an effective approach in performing an appropriate CRT. The rate of responders was high and there was no significant difference in terms of LVEF improvement and EDLVD reduction.