Benefit of quadrapolar left ventricular (LV) lead in improving responder rate even in grossly dilated left ventricles

摘要

Background and aims: Grossly dilated left ventricle (LV) isconsidered to indicate poor response to cardiac resynchronizationtherapy (CRT). We sought to analyze whether quadrapolar LV pacingwould offset this limiting factor in bettering the responder ratesto this novel pacing in patients with dilated cardiomyopathy (DCM)fulfilling all other criteria for CRT.Materials and methods: A total of 256 patients with DCMadmitted to our center from 2004 to date were implanted withcardiac resynchronization therapy – pacemaker (CRT-P) or cardiacresynchronization therapy – defibrillator (CRT-D). Group Aconsisted of 22 patients having grossly dilated LV (Left VentricularInternal Dimension-Diastole, LVIDD≥6 cm) who underwent CRTwith a bipolar LV lead (St Jude). Eleven patients with LVIDD≥6cmunderwent CRT with a quadrapolar LV lead (St Jude) formed groupB, of which 3 had multipoint pacing option as well. The two groupswere followed up for an average period of 10 months (shortestbeing 6 months).