Iranian Heart Journal

Iranian Heart Journal

The Clinical, Electrocardiographic, and Echocardiographic Outcomes of Posterolateral vs Anterolateral Lead Position in Patients With Nonischemic Cardiomyopathy Receiving Cardiac Resynchronization Therapy

Document Type : Original Article

Authors
Elnaz Shahmohammadi 1
Seid Mojtaba Mirabdollahi 1
Masoud Eslami 1
Roya Parkhideh 1
Alireza Barzegary 2
Reza Mollazadeh 1
1 Department of Cardiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran.
2 School of Medicine, Azad University of Medical Sciences, Tehran, IR Iran.
Abstract
Background: Cardiac resynchronization therapy (CRT) is a safe and effective method to treat heart failure (HF) in selected patients after failed medical therapy. We aimed to compare the effects of left ventricular (LV) lead position on the clinical, electrocardiographic (ECG), and echocardiographic parameters in patients with nonischemic cardiomyopathy (NICM) considering the absence of a large regional scar.
 
Methods: Thirty consecutive patients with NICM referred to the Imam Khomeini Hospital Complex for CRT implantation were enrolled in this study. Clinical, ECG, and echocardiographic parameters at baseline and 6 months of follow-up in patients whose left ventricular lead (LV) was implanted in the anterolateral (AL) vs posterolateral (PL) branch of the coronary sinus were compared.
 
Results: The majority of the patients were women (16, 53%). In both groups, functional class improved significantly after CRT implantation, but this decrease was not related to the position of the LV lead. The QRS width in ECG was significantly reduced in the AL group after CRT implantation (from 157.7: 95% CI, 156.13 to 158.27 to 137.3: 95% CI, 133.37 to 141.24; P =0.000). This decrease was also seen in the PL group (from 157.6: 95% CI, 154.26 to 160.01 to 137.6: 95% CI, 133.46 to 141.84; P =0.000), but the decrease was not related to the LV lead position.
 
Conclusions: Our data showed no significant differences in clinical, ECG, or echocardiographic outcomes between PL and AL lead positions in patients receiving CRT. (Iranian Heart Journal 2023; 24(3): 70-76)
Keywords
Cardiac resynchronization therapy
Heart failure
Cardiomyopathies
Nonischemic cardiomyopathy
Coronary sinus lead
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Iranian Heart Journal
Volume 24, Issue 3
Summer 2023
Pages 70-76