MID-TERM FOLLOW UP IN CRT PATIENTS USING ONLY RIGHT ATRIUM AND LEFT VENTRICULAR LEADS WITH FUSION PACING

D. Cozma, E.V. Goanta, C. Vacarescu

Institute of Cardiovascular Disease, Cardiology, Timisoara, Romania

Abstract

Introduction: CRT using only two leads right atrium (RA) and left ventricle (LV) in patients (pts) in sinus rhythm (SR) is less studied, despite numerous potential advantages.
Methods: Thirteen pts (8 male, 5 female), with dilated cardiomyopathy (DCM) were implanted with a dual chamber pacemaker RA and LV leads. All pts were in NYHA Class III, LBBB with normal PR interval. Complete follow-up at 6 month and 2 years included echocardiography, holter monitoring and exercise testing.
Results:Demographic data: DCM etiology: 2 ischemic and 11 idiopathic. Age 58.6 10.9 yo; QRS 166,4 15,2ms; EF 24.44.2%. Mitral regurgitation (MR) severe in 6 pts, moderate 5 pts, mild 2 pts. Average follow-up 29.314.6 months. MR decreased in 5 pts. Average EF was 32.97.0%. LV capture during stress test was lost at maximum exercise in 4 pts and required reprogramming of AV delay. The only pt included with LV aneurysm and prior anterior MI died after 2 years (SCD)..
Conclusions:RA-LV CRT pacing showed a positive outcome in pts without LV aneurysm and prior MI.