Feasibility of biventricular pacing in patients with recent myocardial infarction: impact on ventricular remodeling

• Published in: Congestive heart failure (Greenwich, Conn.) Vol. 13; no. 1; p. 9
• Main Authors: Chung, Eugene S, Menon, Santosh G, Weiss, Raul, Schloss, Edward J, Chow, Theodore, Kereiakes, Dean J, Mazur, Wojciech, Salo, Rodney W, Galle, Elizabeth, Pastore, Joseph M
• Format: Journal Article
• Language: English
• Published: United States 01-01-2007
• Subjects: Aged; Cardiac Pacing, Artificial - methods; Feasibility Studies; Female; Follow-Up Studies; Heart Rate - physiology; Humans; Male; Middle Aged; Myocardial Contraction - physiology; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Retrospective Studies; Treatment Outcome; Ventricular Function, Left - physiology; Ventricular Remodeling
• ISSN: 1527-5299
• DOI: 10.1111/j.1527-5299.2007.05868.x

To test the hypothesis that biventricular pacing after a myocardial infarction with reduced ejection fraction can attenuate left ventricular (LV) remodeling, the authors studied 18 patients (myocardial infarction within 30-45 days, ejection fraction <or=30%, narrow QRS) randomized to biventricular therapy (biventricular therapy + defibrillator) (biventricular group) or implantable cardioverter-defibrillator alone (control group). At 1, 6, and 12 months, there were no differences in functional or clinical parameters (New York Heart Association, quality of life, 6-minute walk). Twelve-month LV volume remained stable in the biventricular group, but increased in the control group (median LV end-diastolic volume increase, 6.5 mL in biventricular vs 35 mL in control; P=.03; median LV end-diastolic volume decrease, 5.5 mL in biventricular vs 30.5-mL increase in control; P=.11). Biventricular therapy also prevented an increase in sphericity index at 12 months (median, -2% in biventricular vs 37% in control; P=.06). Delivery of biventricular therapy early after myocardial infarction appears safe and feasible and may attenuate subsequent LV dilation.