Universität zu Köln

van den Bruck, Jan-Hendrik, Middeldorp, Melissa ORCID: 0000-0002-4106-9771, Sultan, Arian ORCID: 0000-0003-1807-4860, Scheurlen, Cornelia, Seuthe, Katharina, Woermann, Jonas, Filipovic, Karlo, Kadhim, Kadhim, Sanders, Prashanthan, Steven, Daniel and Lueker, Jakob (2023). Impact of ventricular arrhythmia management on suboptimal biventricular pacing in cardiac resynchronization therapy. J. Interv. Card. Electrophysiol., 66 (2). S. 353 - 362. DORDRECHT: SPRINGER. ISSN 1572-8595

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Abstract

Background Reduced biventricular pacing (BiVP) is a common phenomenon in cardiac resynchronization therapy (CRT) with impact on CRT-response and patients' prognosis. Data on treatment strategies for patients with ventricular arrhythmia and BiVP reduction is sparse. We sought to assess the effects of ventricular arrhythmia treatment on BiVP. Methods In this retrospective analysis, the data of CRT patients with a reduced BiVP <= 97% due to ventricular arrhythmia were analyzed. Catheter ablation or intensified medical therapy was performed to optimize BiVP. Results We included 64 consecutive patients (73 +/- 10 years, 89% male, LVEF 30 +/- 7%). Of those, 22/64 patients (34%) underwent ablation of premature ventricular contractions (PVC) and 15/64 patients (23%) underwent ventricular tachycardia (VT) ablation while 27/64 patients (42%) received intensified medical treatment. Baseline BiVP was 88.1%+/- 10.9%. An overall increase in BiVP percentage points of 8.8% (range - 5 to +47.6%) at 6-month follow-up was achieved. No changes in left ventricular function were observed but improvement in BiVP led to an improvement in NYHA class in 24/64 patients (38%). PVC ablation led to a significantly better improvement in BiVP [9.9% (range 4 to 22%) vs. 3.2% (range -5 to +10.7%); p= < 0.001] and NYHA class (12/22 patients vs. 4/27 patients; p = 0.003) than intensified medical therapy. All patients with VT and reduced BiVP underwent VT ablation with an increase of BiVP of 16.3 +/- 13.4%. Conclusion In this evaluation of ventricular arrhythmia treatment aiming for CRT optimization, both medical therapy and catheter ablation were shown to be effective. Compared to medical therapy, a higher increase in BiVP was observed after PVC ablation, and more patients improved in NYHA class.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code van den Bruck, Jan-Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Middeldorp, Melissa UNSPECIFIED orcid.org/0000-0002-4106-9771 UNSPECIFIED Sultan, Arian UNSPECIFIED orcid.org/0000-0003-1807-4860 UNSPECIFIED Scheurlen, Cornelia UNSPECIFIED UNSPECIFIED UNSPECIFIED Seuthe, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Woermann, Jonas UNSPECIFIED UNSPECIFIED UNSPECIFIED Filipovic, Karlo UNSPECIFIED UNSPECIFIED UNSPECIFIED Kadhim, Kadhim UNSPECIFIED UNSPECIFIED UNSPECIFIED Sanders, Prashanthan UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueker, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-676704
DOI:	10.1007/s10840-022-01259-0
Journal or Publication Title:	J. Interv. Card. Electrophysiol.
Volume:	66
Number:	2
Page Range:	S. 353 - 362
Date:	2023
Publisher:	SPRINGER
Place of Publication:	DORDRECHT
ISSN:	1572-8595
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RADIOFREQUENCY ABLATION; HEART-FAILURE; ASSOCIATION; DEFIBRILLATOR; EFFICACY; OUTCOMES; BEATS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67670