© 2000 by European Society of Cardiology
Initial United Kingdom experience with the use of permanent, biventricular pacemakers
Implantation procedure and technical considerations
Department of Cardiology, Harefield Hospital Middlesex, U.K.
AIMS: To describe the institution of a biventricular pacing programme with particular reference to the implantation procedure and new technological considerations.
METHODS AND RESULTS: Analysis of outcomes of a consecutive series of 54 patients undergoing attempted biventricular pacemaker implantation between February 1998 and April 1999. Successful implantation was achieved in 49 of the 54 patients (91%). Five patients required lead repositioning after initial successful implantation. Left ventricular lead pacing thresholds were found to be satisfactory and stable in the long term, with pacing thresholds of 1·3 V, 1·9 V and 1·6 V at implantation, 1 and 3 months, respectively. Left-sided lead function was not dependent on lead position within the tributaries of the coronary sinus. The implantation procedure was found to be safe, although one patient died during long-term follow-up.
CONCLUSION: With appropriate previous experience in complex and coronary sinus pacing and with access to up-to-date pacemaker and lead technology, a biventricular pacemaker implantation service can be instituted with good medium-term results.
Key Words: Biventricular pacemaker, heart failure
Correspondence: Dr S. Walker, Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield NHS Trust, Harefield, Middlesex UB9 6JH, UK
[1] Gras D, Mabo P, Tang T, et al. Multi-site pacing as a supplemental treatment of congestive heart failure: Preliminary results of the Medtronic Inc. InSync study. Pacing Clin Electrophysiol 1998; 21: 2249–2255.[CrossRef][Medline]
[2] Auricchio A, Stellbrink C, Sack S, et al. The pacing therapies for congestive heart failure (PATH-CHF) study: Rationale, design, and endpoints of a prospective randomised multicentre study. Am J Cardiol 1999; 83: 130D–135D.[CrossRef][Web of Science][Medline]
[3] Blanc JJ, Etienne Y, Gilard M. Assessment of left ventricular pacing in patients with severe cardiac failure after atrioventricular node ablation and right ventricular pacing for permanent atrial fibrillation. Europace 1999; 1: 47–48.
[4] Blanc JJ, Etienne Y, Gilard M, et al. Evaluation of different ventricular pacing sites in patients with severe heart failure: results of an acute hemodynamic study. Circulation 1997; 96: 3273–3277.
[5] Saxon LA, Kerwin WF, Cahalan MK, et al. Acute effects of intraoperative multisite ventricular pacing on left ventricular function and activation/contraction sequence in patients with depressed ventricular function. J Cardiovasc Electrophysiol 1998; 9: 13–21.[Web of Science][Medline]
[6] Cazeau S, Ritter P, Lazarus A, et al. Multisite pacing for end-stage heart failure: early experience. Pacing Clin Electrophysiol 1996; 19: 1748–1757.[CrossRef][Medline]
[7] Daubert JC, Ritter P, Le Breton H, et al. Permanent left ventricular pacing with transvenous leads inserted into the coronary veins. Pacing Clin Electrophysiol 1998; 21: 239–245.[CrossRef][Medline]
[8] Jaïs P, Douard H, Shah DC, Barold S, Barat JL, Clementy J. Endocardial biventricular pacing. Pacing Clin Electrophysiol 1998; 21: 2128–2131.[CrossRef][Medline]
[9] Walker S, Levy T, Brant S, Gadd P, Paul V. Utilisation simultanee d'un defibrillateur automatique implantable chez un patient prealablement appareille avec un stimulateur cardiaque biventriculaire pour une insuffisance cardiaque terminale. Arch Mal Coeur 1999; 92: 1795–1799.
[10] Goldman S, Johnson G, Cohn JN, Cintron G, Smith R, Francis G. Mechanism of death in heart failure. The Vasodilator-Heart Failure Trials. The V-HeFT VA Cooperative Studies Group. Circulation 1993; 87: VI24–VI31.
[11] Gregoratos G, Cheitlin MD, Conill A, et al. ACC/AHA Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Executive Summary — a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation). Circulation 1998; 97: 1325–1335.[Medline]
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