Hybrid implantation of Cardiac resynchronization therapy device

  • Alexander Edo Tondas Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, and National Cardiovascular Center Harapan Kita
  • Yoga Yuniadi Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, and National Cardiovascular Center Harapan Kita

Abstract

Recent trials have proven the clinical and functional benefits of cardiac resynchronization therapy (CRT) by biventricular pacing in patients (pts) with severe heart failure and intraventricular conduction delay, principally left bundle branch block (LBBB). However, placement of the transvenous left ventricular lead of CRT device is unsuccessful in 5–10% of patients and a further 20% fail to respond. For these groups, epicardial left ventricular lead placement is one alternative A 75-year-old male patient diagnosed as non ischemic dilated cardiomyopa-thy patient NYHA Class III-IV meeting the clinical initiation criteria of QRS duration > 120 msec, and low ejection fraction (=35%), with worsening symptoms despite one year of medical therapy.A hybrid approach of LV lead implantation by mini thoracostomy and conventional implantation of the RA and RV leads were performed because the coronary sinus cannot be accessed transvenously due to small caliber even after angioplasty. The patient responded quite well to CRT and was discharged with stable he-modynamics, and NYHA Functional Class II.

Downloads

Download data is not yet available.

References

Roger VL, Weston SA, Redfield MM, et al. Trends in heart failure: incidence and survival in a community based population. JAMA 2004;292:344–50.

Hayes DL, Abraham WT. Clinical trials supporting current indications for CRT. In : Yu CM, Hayes DL, Auricchio A, editors. Cardiac Resynchronization Therapy. Massachusetts : Blackwell publishing , 2008.p.266

Abraham WT, Fisher WG, Smith AL, Delurgio DB, Leon AR, Loh E, Kocovic DZ, Packer M, Clavell AL, Hayes DL, Ellestad M, Trupp RJ, Underwood J, Pickering F, Truex C, McAtee P, Messenger J. MIRACLE Study Group. Multicenter InSync Randomized Clinical Evaluation. Cardiac resynchronization in chronic heart failure. N Engl J Med 2002; 346:1845–53.

Salukhe TV, Francis DP, Sutton R. Comparison of medical therapy, pacing and defibrillation in heart failure (COMPAN-ION) trial terminated early; combined biventricular pacemaker-defibrillators reduce all-cause mortality and hospitalization. Int J Cardiol 2003;87:119–20.

St John Sutton MG, Plappert T, Abraham WT, Smith AL, De-Lurgio DB, Leon AR, Loh E, Kocovic DZ, Fisher WG, Ellestad M, Messenger J, Kruger K, Hilpisch KE, Hill MR. Multicenter InSync Randomized Clinical Evaluation (MIRACLE) Study Group. Effect of cardiac resynchronization therapy on left ven-tricular size and function in chronic heart failure. Circulation 2003;107:1985–90.

Cazeau S, Leclercq C, Lavergne T, Walker S, Varma C, Linde C, Garrigue S, Kappenberger L, Haywood GA, Santini M, Bailleul C, Daubert J-C. The multisite stimulation in cardiomyopathies (MUSTIC) Study Investigators. Effects of Multisite Biventricu-lar Pacing in Patients with Heart Failure and Intraventricular Conduction Delay. N Engl J Med 2001;344:873–80.

Ansalone G, Giannantoni P, Ricci R, Trambaiolo P, Fedele F, Santini M. Biventricular pacing in heart failure: back to basics in the pathophysiology of left bundle branch block to reduce the number of nonresponders. Am J Cardiol 2003;91:55F–661.

Patwala A, et al. A prospective longitudinal evaluation of the benefits of epicardial lead placement for cardiac resynchroniza-tion therapy. Europace2009; 11(10): 1323-1329. doi:10.1093/europace/eup251

Imanishi R, Seto S, Ichimaru S, et al. Prognostic significance of incident complete left bundle branch block observed over a 40-year period. Am J Cardiol 2006;98:644–8.

Freudenberger RS, Wilson AC, Lawrence-Nelson J, Hare JM, Kostis JB. Permanent pacing is a risk factor for the development of heart failure. Am J Cardiol 2005;95:671–4

Breithardt, OA. Assessment of electrical and mechanical dyssynchrony:conventional echocardiography. In : Yu CM, Hayes DL, Auricchio A, editors. Cardiac Resynchronization Therapy. Massachusetts : Blackwell publishing , 2008.p.77.

Cazeau S, Bordachar P, Jauvert G et al. Echocardiographic modeling of cardiac dyssynchrony before and during multisite stimulation: a prospective study. Pacing Clin Electrophysiol 2003; 26: 137–143.

Bax JJ et al. Echocardiographic Evaluation of Cardiac Resyn-chronization Therapy: Ready for Routine Clinical Use?A Critical Appraisal. J Am Coll Cardiol 2004;44(1):1-9.

Delhaas T. Prinzen FW. Myocardial mechano-energetics. . In : Yu CM, Hayes DL, Auricchio A, editors. Cardiac Resynchro-nization Therapy. Massachusetts : Blackwell publishing , 2008. pp.60-62.

Kenny T. The Nuts and Bolts of Cardiac Resynchronization Therapy. Massachusetts : Blackwell publishing , 2007.pp.70-75.

Bax JJ et al. Cardiac Resynchronization Therapy: Part 2—Issues During and After Device Implantation and Unresolved Ques-tions. J Am Coll Cardiol 2005;46:2168-2182.

Khan FZ, Virdee MS, Fynn SP, Dutka DP. Left ventricular lead placement in cardiac resynchronization therapy: where and how? Europace 2009;11:554–561.

Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 2004;350:2140–50.

Kowalski O, Lenarczyk R, Prokopczuk J, Pruszkowska-Skrzep P, Zielin´ska T, Sredniawa B et al. Effect of percutaneous in-terventions within the coronarysinus on the success rate of the implantations of resynchronization pacemakers. Pacing Clin Electrophysiol 2006;29:1075–80.

Makaryus AN et al. Coronary Venous Angioplasty and Stenting for Biventricular Pacemaker Left Ventricular Lead Implantation. Invasive Cardiol. 2007;19(5)E128-E130.

Oskar K et al. Effect of Percutaneous Interventions within the Coronary Sinus on the Success Rate of the Implantations of Resynchronization Pacemakers. PACE 2006; 29:1075-1080.

Haas GJ. Abraham WT. Comprehensive pharmacologic man-agement strategies for heart failure. In : Yu CM, Hayes DL, Auricchio A, editors. Cardiac Resynchronization Therapy. Massachusetts : Blackwell publishing,2008.p.30-32.

Gorcsan et al. ASE EXPERT CONSENSUS STATEMENT Echocardiography for Cardiac Resynchronization Therapy: Recommendations for Performance and Reporting–A Report from the American Society of Echocardiography Dyssynchrony Writing Group Endorsed by the Heart Rhythm Society. J Am Soc Echocardiogr 2008;21(3):191-213.

Balaram SK et al. Surgical approaches to epicardial left ven-tricular lead implantation for biventricular pacing . In : Yu CM, Hayes DL, Auricchio A, editors. Cardiac Resynchronization Therapy. Massachusetts : Blackwell publishing , 2008.p.242-246.
Views & Downloads
Abstract views: 886   
PDF downloads: 641   
How to Cite
Tondas, A., & Yuniadi, Y. (1). Hybrid implantation of Cardiac resynchronization therapy device. Indonesian Journal of Cardiology, 31(2), 126-141. https://doi.org/10.30701/ijc.v31i2.146
Section
Case Reports