title: Transesophageal left ventricular posterior wall potential in heart failure patients with biventricular pacing.
abstract: BACKGROUND
  Biventricular (BV) pacing is an established therapy for heart failure (HF) patients with intraventricular conduction delay, but not all patients improved clinically. We investigated the interventricular delay (IVD) by means of the transesophageal left ventricular posterior wall potential (LVPWP).
  
  
  RESULTS
  A total of 18 HF patients (age 62+/-9 years; 15 males) with NYHA class 3.1+/-0.3, LV ejection fraction 22+/-7%, left bundle branch block and a QRS duration (QRSD) of 171+/-27 ms were analyzed using transesophageal LVPWP before implantation of a BV pacing device. The median follow up was 14+/-14 months. In 14 responders, IVD was 81+/-25 ms with a QRSD/IVD ratio of 2.2+/-0.3 with reclassification of NYHA class 3.1+/-0.3 to 2.0+/-0.5 (p<0.001) and an increase in LV ejection fraction from 22+/-7% to 36+/-11% (p=0.001) during long-term BV pacing. In four non-responders, transesophageal IVD was significantly smaller at 30+/-11 ms (p=0.001).
  
  
  CONCLUSIONS
  Transesophageal IVD may be a useful method to detect responders to BV pacing. Transesophageal LVPWP may be a simple and useful technique to detect clinical responders to BV pacing in HF patients.
authors.affiliation: Department of Internal Medicine I, Cardiology Division, Friedrich Schiller University Jena, Jena, Germany. matthias.heinke@med.uni-jena.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Heinke
authors.forename: Ralf
authors.initials: R
authors.lastname: Surber
authors.forename: Helmut
authors.initials: H
authors.lastname: Kühnert
authors.forename: Gudrun
authors.initials: G
authors.lastname: Dannberg
authors.forename: Dirk
authors.initials: D
authors.lastname: Prochnau
authors.forename: Hans R
authors.initials: HR
authors.lastname: Figulla
mesh_terms: D002303:Cardiac Output, Low / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*