Biventricular pacing for severe chronic heart failure; as a single center experience

Abstract

Background: Cardiac resynchronization(CRT) therapy by biventricular pacing(BiV) was reported recently as a therapy for patients with moderate to severe heart failure and ventricular asynchrony. In our country, specialized modality for BiV were available since april, 2004. The aim of our study is to investigate how BiV effects in Japanese patients with severe heart failure. Methods & Results: Fourteen patients (11 males, 3 females, mean age 70.6 +/- 8.8 years), in NYHA class III-IV, underwent CRT by BiV. Three (21.4%) had an ischemic heart disease, four (28.6%) had a previous pacemaker, and six (42.9%) were in chronic atrial fibrillation. One patient (7%) died of severe CHF and VF. One patient (7%) failed CRT because of absence of optimal coronary sinus location. The QRS width, NYHA functional class, left ventricular ejection-fraction (LVEF), left ventricular end-diastolic diameter (LVDd) were measured both before and 1 month after CRT. Comparison of these parameter between before and after CRT, QRS width (180.8 → 144.2 msec, p < 0.0001), NYHA (3.2 → 1.8, p < 0.0001), LVEF(26.8 → 31.0%, p = 0155) were improved significantly, and LVDd were also reduced (63.5 → 62.8 mm, p = 0.2767). Conclusion: Our study suggest that CRT by BiV is very effective therapeutic modality for Japanese patients with severe heart failure.