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Thorac Cardiovasc Surg 2002; 50(2): 67-70
DOI: 10.1055/s-2002-26702
Original Cardiovascular
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Biventricular Pacing in Patients with ICD: How Many Patients are Possible Candidates?

C.  Werling1 , U.  Weiße1 , G.  Siemon2 , A.-H.  Kiessling1 , M.  Rameken2 , H.  Schwacke2 , W.  Saggau1 , J.  Senges2 , K.  Seidl2
  • 1Klinik für Herzchirurgie, Herzzentrum Ludwigshafen, Germany
  • 2Klinik für Kardiologie, Herzzentrum Ludwigshafen, Germany
This paper was presented at the German Society for Thoracic and Cardiovascular Surgery conference on February 16th, 2000 in Leipzig, Germany.
Further Information

Publication History

February 19, 2001

Publication Date:
30 April 2002 (online)

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Abstract

Background: About 80 % of patients receiving an implantable cardioverter-defibrillator (ICD) due to life-threatening episodes of ventricular tachycardia (VT) or ventricular fibrillation (VF) have structural heart disease. ICD implantation reduces the risk of sudden cardiac death to less than 2 %. However, the major obstacle in these patients is chronic heart failure (CHF). Biventricular stimulation (BIV) has shown its efficiency as an alternative therapy in drug refractory CHF. Methods: According to the InSync registry, we predefined possible indications for BIV as follows: complete branch bundle block (> 120 ms), left-ventricular ejection fraction (EF) < 35 % and NYHA class > II. We evaluated the number of patients presenting this indication at time of implant and during follow-up (FU) at our ICD clinic. Results: Between 1992 and 1998, 360 patients were provided with an ICD (mean age 64.6 ± 5.4 yrs, mean EF 37 ± 14 % at implant, 82 % of patients with organic heart disease). Mean FU was 34 ± 21 months. During FU 46 patients (13 %) died, 15 of these (33 %) presenting criteria for BIV. 33 patients died of heart failure, there was 1 sudden death and 12 patients died for non-cardiac reasons. 35 % of the patients who died of heart failure had an indication for BIV. Conclusions: About 10 % of ICD patients had an indication for BIV at time of implant. Over a mean FU period of 34 months, 16% of all patients presented an indication for BIV. Patients with an indication for BIV had a higher mortality rate and more frequent atrial fibrillation compared to patients without. With this data and the good clinical results after BIV-ICD implantation, we consider the implantation of a BIV-ICD system in every patient with appropriate indications.

Key words

Biventricular pacing - ICP - Indication

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1

MD Christiane Werling

Klinik für Herzchirurgie, Herzzentrum Ludwigshafen

Bremserstrasse 79


67063 Ludwigshafen

Germany

Phone: +49 (621) 5 03 40 50

Fax: +49 (621) 5 03 40 60

Email: werlingc@klilu.de