PhD Scientific Days 2020

Clinical Medicine I. Posters

Lateral Left Ventricular Lead Position is Superior to Posterior Position in Long-term Outcome of Patients Underwent Cardiac Resynchronization Therapy

Előadó neve

Dr. Behon, Anett

Előadó munkahelye

Heart and Vascular Center, Semmelweis University

Előadó telefonszáma

+36306591006

Előadó e-mail címe

behona@gmail.com

Az előadás címe

Lateral Left Ventricular Lead Position is Superior to Posterior Position in Long-term Outcome of Patients Underwent Cardiac Resynchronization Therapy

Szerző(k) neve és munkahelye

Anett Behon, M.D., Heart and Vascular Center, Semmelweis University, Budapest
Walter Richard Schwertner, M.D., Heart and Vascular Center, Semmelweis University, Budapest
Eperke Dóra Merkel, M.D., Heart and Vascular Center, Semmelweis University, Budapest
Attila Kovács, M.D., Ph.D., Heart and Vascular Center, Semmelweis University, Budapest
Bálint Károly Lakatos, M.D., Heart and Vascular Center, Semmelweis University, Budapest
Endre Zima, M.D., Ph.D, D.Sc., Heart and Vascular Center, Semmelweis University, Budapest
László Gellér, M.D, Ph.D., D.Sc., Heart and Vascular Center, Semmelweis University, Budapest
Valentina Kutyifa, M.D., Ph.D., Heart and Vascular Center, Semmelweis University, Budapest
Annamária Kosztin, M.D., Ph.D., Heart and Vascular Center, Semmelweis University, Budapest
Béla Merkely, M.D, Ph.D., D.Sc., Heart and Vascular Center, Semmelweis University, Budapest

Szekció

Clinical Medicine I. Posters

Language of the presentation

English

Section, first choice

Clinical Medicine

Section, second choice

Clinical Medicine

Összefoglaló szövege

Introduction: Preferring side branch of coronary sinus during cardiac resynchronization therapy (CRT) implantation is empirical due to the limited data on the association of LV lead position and long-term clinical outcome.
Aims: We evaluated the long-term all-cause mortality by left ventricular (LV) lead non-apical positions and further characterized them by interlead electrical delay (IED).
Method: In our retrospective database 2087 patients were registered between 2000 and 2018. Those with non-apical LV lead locations were classified into anterior (n=108), posterior (n=643), and lateral (n=1336) groups. All-cause mortality was assessed by Kaplan-Meier and Cox analyses. Echocardiographic response was measured 6 months after CRT implantation.
Results: During the median follow-up time of 3.7 years, 1150 (55.1%) patients died, 710 (53.1%) with lateral, 78 (72.2%) with anterior and 362 (56.3%) with posterior positions. Patients with lateral position had significantly better outcome in all-cause mortality compared to others (HR 0.80; 95% CI: 0.71-0.90; p<0.0001), which was also confirmed by multivariate analysis after adjusting for relevant clinical covariates (HR 0.81; 95% CI: 0.72-0.91; p<0.0001). When echocardiographic response was evaluated in the lateral group, patients with an IED longer than 110 ms (ROC AUC 0.63; 95% CI: 0.53-0.73; p=0.012) showed 2.1 times higher odds of improvement in echocardiographic response 6 months after the implantation.
Conclusion: In this study we proved that after CRT implantation only the lateral LV lead location was associated with long-term mortality benefit. Moreover, patients with this position showed the greatest echocardiographic response over 110 ms IED.

Additional Information

Annamária Kosztin
kosztin.annamaria@gmail.com

Bemutatás módja

Poszter

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4608

Start

11:26

End

11:29

Authors (legacy)

Anett Behon, M.D., Heart and Vascular Center, Semmelweis University, Budapest
Walter Richard Schwertner, M.D., Heart and Vascular Center, Semmelweis University, Budapest
Eperke Dóra Merkel, M.D., Heart and Vascular Center, Semmelweis University, Budapest
Attila Kovács, M.D., Ph.D., Heart and Vascular Center, Semmelweis University, Budapest
Bálint Károly Lakatos, M.D., Heart and Vascular Center, Semmelweis University, Budapest
Endre Zima, M.D., Ph.D, D.Sc., Heart and Vascular Center, Semmelweis University, Budapest
László Gellér, M.D, Ph.D., D.Sc., Heart and Vascular Center, Semmelweis University, Budapest
Valentina Kutyifa, M.D., Ph.D., Heart and Vascular Center, Semmelweis University, Budapest
Annamária Kosztin, M.D., Ph.D., Heart and Vascular Center, Semmelweis University, Budapest
Béla Merkely, M.D, Ph.D., D.Sc., Heart and Vascular Center, Semmelweis University, Budapest