Feasibility of biventricular pacing in patients with recent myocardial infarction: impact on ventricular remodeling.
To test the hypothesis that biventricular pacing after a myocardial infarction with reduced ejection fraction can attenuate left ventricular (LV) remodeling, the authors studied 18 patients (myocardial infarction within 30-45 days, ejection fraction <or=30%, narrow QRS) randomized to biventricular therapy (biventricular therapy + defibrillator) (biventricular group) or implantable cardioverter-defibrillator alone (control group). At 1, 6, and 12 months, there were no differences in functional or clinical parameters (New York Heart Association, quality of life, 6-minute walk). Twelve-month LV volume remained stable in the biventricular group, but increased in the control group (median LV end-diastolic volume increase, 6.5 mL in biventricular vs 35 mL in control; P=.03; median LV end-diastolic volume decrease, 5.5 mL in biventricular vs 30.5-mL increase in control; P=.11). Biventricular therapy also prevented an increase in sphericity index at 12 months (median, -2% in biventricular vs 37% in control; P=.06). Delivery of biventricular therapy early after myocardial infarction appears safe and feasible and may attenuate subsequent LV dilation.
Chung
Eugene S
ES
The Christ Hospital, Ohio Heart and Vascular Center, and the Lindner Clinical Trial Center, Cincinnati, OH 45219, USA. chunge@ohioheart.org
Menon
Santosh G
SG
Weiss
Raul
R
Schloss
Edward J
EJ
Chow
Theodore
T
Kereiakes
Dean J
DJ
Mazur
Wojciech
W
Salo
Rodney W
RW
Galle
Elizabeth
E
Pastore
Joseph M
JM
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling