Key result
The distance from the middle cardiac vein to the left ventricular lead tributary was not significantly different between CRT responders and non-responders (44.8 vs 37.8 mm; p=0.531).
Why the study?
A high number of patients receiving cardiac resynchronization therapy remain nonresponsive despite appropriate selection criteria and technological advances.
Does the distance between the left ventricular lead and the middle cardiac vein ostium affect the response to cardiac resynchronization therapy in patients receiving CRT?
Observational (n=53)
Does the distance between the left ventricular lead and the middle cardiac vein ostium affect the response to cardiac resynchronization therapy in patients receiving CRT?
Absolute Event Rate: 44.8% vs 37.8%
p-value: p=0.531
The distance between the LV lead tributary and the middle cardiac vein may correlate with reduced heart failure hospitalizations following CRT implantation, despite not differing significantly between overall responders and non-responders.
Objective: Despite appropriate patient selection criteria and procedural information and technological advances, a high number of patients with cardiac resynchronization therapy (CRT) still remains nonresponsive to treatment.In this study, it was aimed to investigate the relation between the distance between the middle cardiac vein (MCV) and the placement of the left ventricular (LV) lead and the response to CRT implantation.Material and Methods: Angiographic and clinical data of a total of 53 patients were analyzed retrospectively.Patients were divided into two separate groups as responders and non-responders according to the benefit of CRT after at least six months of clinical follow-up.The distance between the coronary sinus (CS) branch where the LV lead was placed and the MCV ostium was measured, and the relation between this distance and response to CRT was examined.Results: Mean age of the patients was 63.53 ± 11.11 years, and 19 (35.8%) patients were females.Ischemic etiology was significantly higher in the non-responders group than in the responder group [14 patients (41.2%) vs 13 patients (72.2%), p= 0.031].The distance from MCV to the tributary where LV lead was placed was not statistically different between the groups (44.8 ± 18.3 mm vs. 37.8 ± 17.3 mm; p= 0.531); however, this distance was significantly correlated with the reduction of hospitalization after implantation of the CRT. Conclusion:In general, the recommended target for the location of the LV lead in CRT implantation is the lateral and posterior tributaries of the CS, nevertheless this issue has not been clearly clarified.In this study, we found that the distance between the LV lead tributary and MCV may be associated with a decrease in the frequency of hospitalization due to heart failure.
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Pirhan et al. (2023) conducted an observational in Heart failure patients receiving cardiac resynchronization therapy (n=53). Distance between the middle cardiac vein and the placement of the left ventricular lead vs. Responders vs non-responders was evaluated on Distance from the middle cardiac vein to the tributary where the left ventricular lead was placed (p=0.531). The distance from the middle cardiac vein to the left ventricular lead tributary was not significantly different between CRT responders and non-responders (44.8 vs 37.8 mm; p=0.531).
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