Logo do repositório
 
Publicação

Right ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?

2018Artigo científico Acesso aberto
Ver registo simples
dc.contributor.authorGoncalves, I. S. S.
dc.contributor.authorMarques, P.
dc.contributor.authorHyde Congo, K.
dc.contributor.authorRibeiro Agostinho, João Pedro
dc.contributor.authorAguiar-Ricardo, Inês
dc.contributor.authorRigueira, Joana
dc.contributor.authorNunes-Ferreira, Afonso
dc.contributor.authorSantos, R.
dc.contributor.authorSousa, Joana
dc.date.accessioned2019-11-04T16:12:08Z
dc.date.available2019-11-04T16:12:08Z
dc.date.issued2018
dc.description© The European Society of Cardiology 2018. All rights reserved.pt_PT
dc.description.abstractIntroduction: The most recent studies in cardiac resynchronization therapy (CRT) have been focused on attempts to improve response rate, such as the determination of the optimal placement of the left ventricular (LV) lead. The position of the LV lead guided by the site of latest electrical delay (ED), seems to be a promising strategy. The same strategy may be useful in assessing the ideal positioning of right ventricular (RV) lead in CRT. Purpose: To determine the most favorable position of the RV lead (septal versus apical) in CRT, by measuring the ED of the LV poles during septal or apical RV pacing in patients with triple-site CRT (TRIV). Methods: A single-center prospective study of consecutive patients (Oct. 2014 to Oct. 2017) submited to CRT device implantation (Quadra Allure MPTM, which allows post-implantation ED measurement) in TRIV mode - with a quadripolar lead in the LV, a RV lead positioned at the septum and a RV lead at the apex. In the follow-up, the lead position was confirmed and determined by fluoroscopic evaluation (anterior, lateral and postero-lateral in the short axis and basal, mid and apical on the long axis). The ED was measured at the 4-pole LV lead, during apical and septal RV pacing and the relation between the ED and lead position was evaluated. Results: Twenty two patients were included: 82% male, median age 78 years; 50% implanted CRT with defibrillator; 27% had ischemic heart disease and 73% non-ischemic etiology; all patients had permanent atrial fibrillation and the QRS duration was of 176±29ms. The position of the LE lead poles was classified as lateral in 44% and postero-lateral in 56%, basal in 28%, medial in 39% and apical in 34%. We evaluated 160 ED. The mean ED between the apical RV lead and the LV poles was significantly higher than the delay between septal RV lead and the LV poles [161±33ms vs 75±45ms (p<0.001)]. This difference remained significant in LV poles located in a lateral position (76±62 vs. 166±36ms; p<0.001) or in a postero-lateral position (74±30 vs. 157±31ms; p<0.001); the same ocurred for LV poles in a basal (99±62 vs. 179±24ms, p<0.001), mid (72±38 vs. 167±31ms, p<0.001) and apical location (57±24 vs. 140±32ms, p<0.001). Conclusion: The LV lead position is an important determinant of the success of CRT, but is conditioned by anatomical and technical characteristics. The optimization of CRT may then depend on the positioning of RV lead. This study demonstrated that the apical (vs. septal) RV lead positioning presents higher ED in relation to LV lead, regardless of the latter position.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEuropean Heart Journal, Volume 39, Issue suppl_1, August 2018, ehy566.P5741pt_PT
dc.identifier.doi10.1093/eurheartj/ehy566.P5741
dc.identifier.issn0195-668X
dc.identifier.urihttp://hdl.handle.net/10451/40044
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Presspt_PT
dc.relation.publisherversionhttps://academic.oup.com/eurheartjpt_PT
dc.titleRight ventricular lead in cardiac resynchronization therapy : what is the most electrically favorable stimulation site?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issuesuppl_1pt_PT
oaire.citation.titleEuropean Heart Journalpt_PT
oaire.citation.volume39pt_PT
person.familyNameRibeiro Agostinho
person.familyNameAguiar-Ricardo
person.familyNameRigueira
person.familyNameNunes-Ferreira
person.givenNameJoão Pedro
person.givenNameInês
person.givenNameJoana
person.givenNameAfonso
person.identifier.ciencia-idD012-F874-3DA7
person.identifier.ciencia-id0419-C014-BA22
person.identifier.orcid0000-0002-4778-5066
person.identifier.orcid0000-0002-9951-1104
person.identifier.orcid0000-0003-1014-537X
person.identifier.orcid0000-0002-2836-9497
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication778547ca-51a0-46a0-9af2-30998f6ac95d
relation.isAuthorOfPublication5dd978c7-1c24-4091-ae7d-406ea82c0a00
relation.isAuthorOfPublication249aa7ae-db14-4208-8d36-1f27bbec254c
relation.isAuthorOfPublicationea30d6c6-61a5-4dc8-a175-d4b3631c168a
relation.isAuthorOfPublication.latestForDiscovery778547ca-51a0-46a0-9af2-30998f6ac95d

Ficheiros

Principais
A mostrar 1 - 1 de 1
Miniatura
Nome:
P5741.pdf
Tamanho:
409.01 KB
Formato:
Adobe Portable Document Format
Ver/Abrir
Licença
A mostrar 1 - 1 de 1
Miniatura indisponível
Nome:
license.txt
Tamanho:
1.2 KB
Formato:
Item-specific license agreed upon to submission
Descrição:
Ver/Abrir

Coleções

FM-CCUL-Artigos em Revistas Internacionais