Why the study?
Does optimal left ventricular lead placement improve the percentage of echocardiographic responders in post-myocardial infarction heart failure patients undergoing CRT?
Does optimal left ventricular lead placement improve the percentage of echocardiographic responders in post-myocardial infarction heart failure patients undergoing CRT?
Targeting left ventricular lead placement downstream of the ischemic area significantly increases the rate of echocardiographic response to CRT in post-MI heart failure patients.
CRT lead placement relative to infarct site may affect response in post-MI HF; leaves open optimal strategy for randomized confirmation.
AIM: To evaluate at a 12-month follow-up, the clinical and echocardiographic outcomes in postmyocardial infarction (MI) heart failure patients who underwent cardiac resynchronization therapy (CRT) device implantation. MATERIALS & METHODS: A total of 100 patients received a CRT device, and the study population was divided into three groups, according to the site of MI and left ventricular (LV) lead placed downstream of the ischemic area, as evaluated by echocardiography. RESULTS: At the end of the 12-month follow-up, we reported a general improvement of LV ejection fraction from 28 ± 7% to 35 ± 9% (p < 0.001) and a significant reverse remodeling: LV end-systolic volume changed from 147 ± 54 to 125 ± 63 (p = 0.001) with a 53% of echocardiographic responders. We also observed 67% of CRT responders in the group with optimal LV lead placement compared with 38% in the remaining population (p = 0.01). CONCLUSION: The optimal positioning of LV lead is a feasible method to improve the percentage of CRT responders in post-MI heart failure patients.
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Muto et al. (2018) studied this question.
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