Pacing Inter-lead Fluoroscopic RAO and LAO Distance and Cardiac Resynchronization Therapy Response
|Zoppo F1*, Berton A1, Zerbo F1, Frigato N1, Michieletto M1, Zanocco A1, Lupo A1, Bacchiega E1, Brandolino G1, Reimers B1 and Bertaglia E2|
|1Cardiology Department Mirano (Venice), Italy|
|2Cardiology Clinic University of Padua, Italy|
|Corresponding Author :||Franco Zoppo
Electrophysiology Laboratory, Department of Cardiology
Hospital Mirano, Mirano, Venice, Italy
E-mail: [email protected]
|Received July 09, 2014; Accepted September 10, 2014; Published September 27, 2014|
|Citation: Zoppo F, Berton A, Zerbo F, Frigato N, Michieletto M, et al. (2014) Pacing Inter-lead Fluoroscopic RAO and LAO Distance and Cardiac Resynchronization Therapy Response. J Clin Exp Cardiolog 5:336. doi:10.4172/2155-9880.1000336|
|Copyright: © 2014 Zoppo F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objective: The Inter-lead Distance (ILD) between the Right and Left Ventricular (RV and LV) pacing leads may play a role in Cardiac Resynchronization Therapy (CRT) response. We sought to measure the ILD during the CRT procedure in the Left and Right Anterior Oblique (LAO and RAO) fluoroscopy projections and correlated these measurements with Trans-Thoracic Echocardiographic (TTE) reverse remodeling. The ILD was measured in the LAO and RAO projections to obtain 2 direct (LAO ILD and RAO ILD) and 1 merged bi-dimensional (LAO ILD×RAO ILD Index) body surface-normalized indexes.
Methods and results: Between January and December 2010, 48 consecutive CRT patients were enrolled (15/48, 31.2% with upgrading indications). Fourty-five patients (mean age 72.6 ± 9 years, 28 males) completed the TTE follow up at mean of 12.3 ± 7.8 months. They were divided into CRT “responders” and “non-responders” according to the combined endpoint of LV Ejection Fraction (LVEF) improvement and LV End-Systolic Volume (ESV) reduction. Twenty-five (55%) patients were classified as responders. No difference in the 3 ILD indexes was found between responders and non-responders. In the univariate analysis, non-responders patients were more frequently affected by an ischemic cardiomyopathy and by a previous anterior myocardial infarction (Table 2). In the further multivariate analysis, no variable characterized the study groups.
Conclusions: In our study, the mono and bi-dimensional ILD failed to predict a reverse remodeling in CRT patients.