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Right ventricular l...
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Rönn, FolkeUmeå universitet,Kardiologi
(författare)
Right ventricular lead positioning does not influence the benefits of cardiac resynchronization therapy in patients with heart failure and atrial fibrillation.
- Artikel/kapitelEngelska2011
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2011-06-28
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Oxford University Press,2011
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LIBRIS-ID:oai:DiVA.org:umu-49358
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-49358URI
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https://doi.org/10.1093/europace/eur193DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:art swepub-publicationtype
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Aims Little is known about the optimal right ventricular (RV) pacing site in cardiac resynchronization therapy (CRT). This study compares bi-ventricular pacing at the left ventricular (LV) free wall combined with two different RV stimulation sites: RV outflow tract (RVOT+LV) vs. RV-apex (RVA+LV). Methods and results Thirty-three patients (32 males) with chronic heart failure, NYHA class III-IV, optimal drug therapy, QRS-duration ≥150 ms, and chronic atrial fibrillation (AF) received CRT with two different RV leads, in the apex (RVA) or outflow tract (RVOT), together with an LV lead, all connected to a bi-ventricular pacemaker. Randomization to pacing in RVOT+LV or RVA+LV was made 1 month after implantation and cross-over to the alternate pacing configuration occurred after 3 months. The median age of patients was 69 ± 10 years, the mean QRS was 179 ± 23 ms, and 58% of patients had ischaemic heart disease. Seven patients had pacemaker rhythm at inclusion and 60% were treated with atrioventricular-junctional ablation before randomization. In the RVA+LV and RVOT+LV pacing modes, 67 and 63% (nonsignificant) responded symptomatically with a decrease of at least 10 points in the Minnesota Living with Heart Failure score. The secondary end-points (6-min walk test, peak oxygen uptake, N-Terminal fragment of B-type Natriuretic Peptide, and left ventricular ejection fraction) showed significant improvement between baseline and CRT, but not between RVOT+LV and RVA+LV. Conclusion In this randomized controlled study, the exact RV pacing site, either apex or outflow tract, did not influence the benefits of CRT in a group of patients with chronic heart failure and AF. ClinicalTrials.gov ID: NCT00457834.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Kesek, MilosUmeå universitet,Kardiologi(Swepub:umu)mike0005
(författare)
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Karp, KjellUmeå universitet,Klinisk fysiologi(Swepub:umu)kjka0001
(författare)
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Henein, MichaelUmeå universitet,Kardiologi(Swepub:umu)mihe0015
(författare)
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Jensen, Steen MUmeå universitet,Kardiologi(Swepub:umu)stje0001
(författare)
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Umeå universitetKardiologi
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Europace: Oxford University Press13:12, s. 1747-17521099-51291532-2092
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