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 24.4±4.2%. Mitral regurgitation (MR) severe in 6 pts, moderate 5 pts, mild 2 pts. Average follow-up 29.3±14.6 months. MR decreased in 5 pts. Average EF was 32.9±7.0%. 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.