%0 Journal Article
%T Local electrogram delay recorded from left ventricular lead at implant predicts response to cardiac resynchronization therapy: Retrospective study with 1 year follow up
%A Rostislav Polasek
%A Pavel Kucera
%A Pavel Nedbal
%A Tomas Roubicek
%A Tomas Belza
%A Jana Hanuliakova
%A David Horak
%A Dan Wichterle
%A Josef Kautzner
%J BMC Cardiovascular Disorders
%D 2012
%I BioMed Central
%R 10.1186/1471-2261-12-34
%X We conducted a retrospective, single¨Ccentre analysis of 161 consecutive patients with heart failure and LBBB or nonspecific intraventricular conduction delay (IVCD) treated with CRT. We routinely intend to implant the LV lead in a region with long QLV. Clinical response to CRT, left ventricular (LV) reverse remodelling (i.e. decrease in LV end-systolic diameter - LVESD ¡Ý10%) and reduction in plasma level of NT-proBNP >30% at 12-month post-implant were the study endpoints. We analyzed association between pre-implant variables and the study endpoints.Clinical CRT response rate reached 58%, 84% and 92% in the lowest (¡Ü105£¿ms), middle (106-130£¿ms) and the highest (>130£¿ms) QLV tertile (p£¿<£¿0.0001), respectively. Longer QRS duration (p£¿=£¿0.002), smaller LVESD and a non-ischemic cardiomyopathy (both p£¿=£¿0.02) were also univariately associated with positive clinical CRT response. In a multivariate analysis, QLV remained the strongest predictor of clinical CRT response (p£¿<£¿0.00001), followed by LVESD (p£¿=£¿0.01) and etiology of LV dysfunction (p£¿=£¿0.04). Comparable predictive power of QLV for LV reverse remodelling and NT-proBNP response rates was observed.LV lead position assessed by duration of the QLV interval was found the strongest independent predictor of beneficial clinical response to CRT.
%K Cardiac resynchronization therapy
%K Reverse remodelling
%K LV lead location
%K Electrical dyssynchrony
%U http://www.biomedcentral.com/1471-2261/12/34/abstract