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



Shahmohammadi E¹ ; Mirabdollahi SM¹ ; Eslami M¹ ; Parkhideh R¹ ; Barzegary A² ; Mollazadeh R¹ Show Affiliations
Source: Iranian Heart Journal Published:2023

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. © 2023, Iranian Heart Association. All rights reserved.