Academic Journal
Relationship of Electromechanical Dyssynchrony in Patients Submitted to CRT With LV Lead Implantation Guided by Gated Myocardial Perfusion Spect
| العنوان: | Relationship of Electromechanical Dyssynchrony in Patients Submitted to CRT With LV Lead Implantation Guided by Gated Myocardial Perfusion Spect |
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| المؤلفون: | Erivelton Alessandro do Nascimento, Christiane Cigagna Wiefels Reis, Fernanda Baptista Ribeiro, Christiane Rodrigues Alves, Eduardo Nani Silva, Mario Luiz Ribeiro, Claudio Tinoco Mesquita |
| المصدر: | Arquivos Brasileiros de Cardiologia, Iss 0 (2018) |
| بيانات النشر: | Sociedade Brasileira de Cardiologia (SBC), 2018. |
| سنة النشر: | 2018 |
| المجموعة: | LCC:Diseases of the circulatory (Cardiovascular) system |
| مصطلحات موضوعية: | Heart Failure, Cardiac Resynchronization Therapy, Eletrodes,Implanted, Stroke Volume, Radionuclide Imaging, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| الوصف: | Abstract Background: Heart failure (HF) affects more than 5 million individuals in the United States, with more than 1 million hospital admissions per year. Cardiac resynchronization therapy (CRT) can benefit patients with advanced HF and prolonged QRS. A significant percentage of patients, however, does not respond to CRT. Electrical dyssynchrony isolated might not be a good predictor of response, and the last left ventricular (LV) segment to contract can influence the response. Objectives: To assess electromechanical dyssynchrony in CRT with LV lead implantation guided by GATED SPECT. Methods: This study included 15 patients with functional class II-IV HF and clinically optimized, ejection fraction of 35%, sinus rhythm, left bundle-branch block, and QRS ≥ 120 ms. The patients underwent electrocardiography, answered the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and underwent gated myocardial perfusion SPECT up to 4 weeks before CRT, being reassessed 6 months later. The primary analysis aimed at determining the proportion of patients with a reduction in QRS duration and favorable response to CRT, depending on concordance of the LV lead position, using chi-square test. The pre- and post-CRT variables were analyzed by use of Student t test, adopting the significance level of 5%. Results: We implanted 15 CRT devices, and 2 patients died during follow-up. The durations of the QRS (212 ms vs 136 ms) and the PR interval (179 ms vs 126 ms) were significantly reduced (p < 0.001). In 54% of the patients, the lead position was concordant with the maximal delay site. In the responder group, the lateral position was prevalent. The MLHFQ showed a significant improvement in quality of life (p < 0.0002). Conclusion: CRT determines improvement in the quality of life and in electrical synchronism. Electromechanical synchronism relates to response to CRT. Positioning the LV lead in the maximal delay site has limitations. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English Portuguese |
| تدمد: | 1678-4170 |
| Relation: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018005012103&lng=en&tlng=en; https://doaj.org/toc/1678-4170 |
| DOI: | 10.5935/abc.20180159 |
| URL الوصول: | https://doaj.org/article/8b28ba3b09ba456785381ee9a97849a8 |
| رقم الانضمام: | edsdoj.8b28ba3b09ba456785381ee9a97849a8 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 16784170 |
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| DOI: | 10.5935/abc.20180159 |