Quadripolar leads are associated with better results according to bipolar leads in cardiac resynchronization therapy in one-year follow-up: Multicenter, retrospective study

Ramazan Gündüz; Songül Usalp

doi:10.19161/etd.1086122

TR EN

Kuadripolar sol ventrikül leadler, bir yıllık takipte kardiyak resenkronizasyon tedavisinde bipolar leadlere göre daha iyi sonuçlarla ilişkilidir: Çok merkezli, retrospektif çalışma

Öz

Amaç: Bu çalışmada, bir yıllık takipte kuadripolar sol ventrikül leadi veya bipolar sol ventrikül leadi ile kardiyak resenkronizasyon tedavisi uygulanan hastaları karşılaştırdık. Kardiyak resenkronizasyon tedavisi sonrası NYHA (New York Heart Association) sınıflaması, elektrokardiyografi ve ekokardiyografi parametrelerinin lead tipine göre bir yıllık takipteki düzelmelerini araştırdık. Gereç ve Yöntem: Bu çalışmada 91 hasta sırasıyla bipolar sol ventrikül lead'i ve kuadripolar sol ventrikül lead'i olarak kaydedildi. 40 hasta kuadripolar sol ventrikül lead'i ve 51 hasta bipolar sol ventrikül leadi takıldı. Bulgular: Bir yıllık takipte kardiyak resenkronizasyon tedavisi tedavisinden sonra, ≥1 NYHA iyileşmesi olan hastalar %80'e karşı %56,8, p=0.006 ve sol ventrikül ejeksiyon fraksiyonu ≥%5 %77,5’ya karşılık %54,9, p=0.031 ve QRS süresi 140,4 idi. ±11,7 vs 151,7±19,4 p=0.018 ms, sırasıyla kuadripolar ve bipolar sol ventrikül leadinde. Tek değişkenli regresyon analizi, sol ventrikül ejeksiyon fraksiyonu (OR:1.082 %95 CI [1.005–1.165], p=0.037), QRS süresi (OR:0.980 %95 CI [0.961–0.999], p=0.038), NYHA sınıfı (OR:1.107 %95 GA [0.075-0.682], p=0.008) ve sol ventrikül ejeksiyon fraksiyonu iyileşmesi (OR:2.959 %95 CI [1.083-8.086], p=0.034) kardiyak kardiyak resenkronizasyon tedavisi uygulanan ve kuadripolar sol ventrikül leadi uygulananlarda bipolar sol ventrikül leadi takılanlara göre daha iyi yanıtla ilişkili bulundu. Sonuç: Kardiyak resenkronizasyon tedavisi uygulanan hastalarda uzun dönem takipte QRS süresini kısaltmak, sol ventrikül ejeksiyon fraksiyonunu ve NYHA'yı daha iyi iyileştirmek için bipolar sol ventrikül leadi yerine kuadripolar sol ventrikül leadi seçilmelidir.

Anahtar Kelimeler

Quadripolar leads are associated with better results according to bipolar leads in cardiac resynchronization therapy in one-year follow-up: Multicenter, retrospective study

Abstract

Aim: In this study, we compared patients who were performed cardiac resynchronization therapy with quadripolar left ventricle lead or bipolar left ventricle lead in one-year follow-up. We investigated the relationship between the improvements of New York Heart Association classification, electrocardiography and echocardiography parameters according to lead type at one-year follow-up after CRT treatment. Materials and Methods: In this study, 91 patients were enrolled respectively as bipolar left ventricle lead and quadripolar left ventricle lead. 40 patients are quadripolar left ventricle lead and 51 patients are bipolar left ventricle lead. Results: After cardiac resynchronization therapy treatment in one year follow-up, patients with ≥1 NYHA improvement was 80% vs 56.8%, p=0.006 and left ventricular ejection fraction ≥5% was 77.5% vs 54.9%, p=0.031 and QRS duration 140.4±11.7 vs 151.7±19.4 ms, p=0.018 in quadripolar and bipolar left ventricle lead respectively. The univariable regression analysis revealed that left ventricular ejection fraction (OR:1.082 95%CI [1.005–1.165], p=0.037), QRS duration (OR:0.980 95%CI [0.961–0.999], p=0.038), NYHA class (OR:1.107 95%CI [0.075–0.682], p=0.008) and left ventricular ejection fraction improvement (OR:2.959 95%CI [1.083–8.086], p=0.034) were better response cardiac resynchronization therapy with quadripolar left ventricle rather than bipolar left ventricle lead.

Conclusion: Qdp LVL can be considered instead of BiP LVL to shorten QRS duration and better improve LVEF and NYHA in patients undergoing CRT in long-term follow-up

Keywords

References

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Ramazan Gündüz ^*
0000-0001-7133-4604
Türkiye

Songül Usalp
0000-0001-9572-5431
Türkiye

Publication Date

March 15, 2022

Submission Date

October 4, 2021

Acceptance Date

February 14, 2022

Published in Issue

Year 2022 Volume: 61 Number: 1

DOI

https://doi.org/10.19161/etd.1086122

IZ

https://izlik.org/JA72BJ72DD

Cite

RIS / Bibtex

Vancouver

1.Ramazan Gündüz, Songül Usalp. Quadripolar leads are associated with better results according to bipolar leads in cardiac resynchronization therapy in one-year follow-up: Multicenter, retrospective study. EJM. 2022 Mar. 1;61(1):87-92. doi:10.19161/etd.1086122