Key result
The 12-lead electrocardiogram successfully unmasked loss of left ventricular capture in 6 patients who failed to respond to cardiac resynchronization therapy.
Why the study?
Does the 12-lead ECG help identify loss of left ventricular capture in patients who are nonresponders to cardiac resynchronization therapy?
Case Report (n=6)
Does the 12-lead ECG help identify loss of left ventricular capture in patients who are nonresponders to cardiac resynchronization therapy?
The 12-lead ECG remains a simple and invaluable tool for identifying loss of left ventricular capture in patients who do not respond to cardiac resynchronization therapy.
May support 12-lead ECG review in CRT nonresponders; leaves open prospective validation before practice change.
BACKGROUND: The aim of cardiac resynchronization therapy (CRT) is to restore myocardial electromechanical synchrony. Achieving this in patients with chronic severe heart failure due to poor left ventricular (LV) systolic function and cardiac dyssynchrony on optimal medical therapy, is associated with improved clinical performance and outcomes. Up to one-third of patients undergoing CRT do not benefit from implantation. Ensuring LV capture is essential and can be at times difficult to confirm. METHODS: Described herein, are six patients who underwent biventricular pacemaker implantation but failed to experience an improvement in LV systolic function or functional capacity. RESULTS: In each case, the 12-lead electrocardiogram (ECG) was helpful in unmasking loss of LV capture in patients who were presumed to have biventricular pacing. CONCLUSIONS: Despite the technical wizardry behind CRT and patient system analyzers, the surface ECG should continue to be an invaluable tool for evaluating patients who have undergone CRT.
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Sabbagh et al. (2010) conducted a case report in Chronic severe heart failure (n=6). 12-lead electrocardiogram (ECG) was evaluated on Identification of loss of left ventricular capture. The 12-lead electrocardiogram successfully unmasked loss of left ventricular capture in 6 patients who failed to respond to cardiac resynchronization therapy.
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