Impact Of Right Ventricular Lead Position To Cardiac Resynchronization Therapy Efficacy

Objective: To investigate if Right ventricular mid-septum,RVMS could further improve the treatment effects compared with Right ventricular apex,RVA in the patients receiving cardiac resynchronization therapy(CRT).Methods:Between January 2001 and June 2015 a total of 386 CRT-P/D patients were enrolled in this study.Average age 60.8 ±12.2 years,female 27.7%.The enrolled patients were divided into two groups based on the RV lead location,RVMS 155 and RVA231,at 6 months follow up,the Echocardiographic characteristics were compared,including LVEDV、LVESV、LVEF、SDI、QRS duration,and clinical outcomes like the NYHA class were compared too.the time to first HF hospitalization or death were recorded in 12 moths.Results:After 6 moths follow up,the QRS duration was shortened by 19.23 ±11.65 vs 17.4±11.88 and 0.14% respectively.the Echo parameters and cardiac function of the two groups improved significantly,but no difference were found between the two groups.LVEF(8.94±5.42 VS 8.75±5.51,P=0.74);LVEDV(19.43±12.19 VS 20.19±12.88,P=0.56);LVESV(35.9±21.5 VS 36.6±22.9,P=0.77),LVESV decrease>15%(60% VS 62%,p=0.58).NYHA improvement(1.01±0.37 vs 1.10±0.36 p0.42).first HF hospitalization or death time occured(RVMS16.8% vs RVA19.5%)with no significantly difference between the two groups in 12 moths(P = 0.50).Conclusions: Compared wiht RVA,RVMS could not improve Cardiac systolic synchrony 、clinical symptoms and prognosis...