Original articleAdult cardiacProphylactic Epicardial Left Ventricular Lead Implantation for Biventricular Pacing During Operations
Section snippets
Patients and Methods
The Institutional Ethics Committee approved publication of this study and the use of LV leads and patient data within the database.
The study included all patients undergoing cardiac operations between January 2001 and December 2011 in our institution. Data were retrieved retrospectively from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons database and from patient medical records. A detailed description of data collection and validation has been previously described [9].
Results
Between June 2001 and December 2011, 4,844 consecutive patients underwent cardiac operations with a median sternotomy. Full results are provided in Table 1.
Clinical symptoms of heart failure were evident in 3,308 patients (68.3%) with NYHA class II, III, or IV symptoms. According to our criteria, 380 patients (7.8%), with a mean age of 66.5 ± 11.0 years, had impaired LV function, and 338 (88.9%) were in NYHA class II, III, or IV. There were statistically significant differences in most
Comment
Our study identifies a significant subgroup of patients with impaired LV function who can benefit from concomitant prophylactic LV lead implantation. To our knowledge, this is the largest database of patients undergoing prophylactic LV lead implantation during cardiac operations.
Transvenous LV lead placement is currently considered the first-line approach for cardiac resynchronization therapy but is unsuccessful in up to 10% of patients due to technical factors, such as inability to cannulate
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