[CRT-FORUM] 64E Predictive value of the electrical axis. Dr. Perez Riera

[CRT-INFO]

Dear Dr. Alfredo Cagnolatti, I know both the Javier manuscript and Rio
Cuarto.

García-Seara J, Martínez-Sande JL, Cid B, Gude F, Bastos M, Domínguez M,
Varela A, González-Juanatey JR. Influence of the preimplantation QRS axis on
responses to cardiac resynchronization therapy. Rev Esp Cardiol. 2008
Dec;61:1245-1252
Servicio de Cardiología, Hospital Clínico Universitario, Santiago de
Compostela, A Coruña, Spain. javiergarciaseara at yahoo.es

INTRODUCTION AND OBJECTIVES: The aim of this study was to determine whether
measurement of the QRS axis can help to predict outcome in patients
undergoing cardiac resynchronization therapy. METHODS: The study included 78
patients who had undergone successful cardiac resynchronization device
implantation. Patients were classified as having either a normal QRS axis
(i.e., between -30 degrees and +120 degrees) or a left QRS axis deviation
(i.e., between -30 degrees and -90 degrees). Patients were regarded as
responders if they fulfilled all of the following criteria: their functional
class improved by at least one grade, their left ventricular ejection
fraction increased by at least 5%, they did not need hospitalization for
worsening heart failure, and they were still alive at 12-month follow-up.
RESULTS: After adjustment for age, preimplantation left ventricular ejection
fraction, etiology and mitral regurgitation, a statistically significant
interaction was found between the QRS axis and lead location (P=.026). There
was a better response with an anterior lead location if the patient had a
left QRS axis deviation. CONCLUSIONS: A significant interaction was found
between the lead location and the preimplantation QRS electrical axis, such
that there was a better response to resynchronization therapy when the lead
was implanted in the anterior interventricular vein if the patient had a
left QRS axis deviation.
PMID: 19080962 [PubMed - in process]

If somewhere needs the full text, I can send the article.

Río Cuarto is a city in the province of Córdoba, Argentina. Located in the
south of the province, it has about 144,000 inhabitants and is an important
commercial and agricultural hub. It was founded in 1786 as "Villa de la
Concepción del Río Cuarto", by the then-Governor Rafael de Sobremonte. This
city is famous by its beautiful woman


All the best for all
Andrés Ricardo Pérez Riera.MD
Chief of electrovectorcardiographic sector. ABC’s Medical School, ABC
Foundation, Santo André, São Paulo, Brazil Riera at uol.com.br

> Thank you for your comment, dear Dr. Perez Riera, I guess you know the
> "iiiiiiimpeeerio"! I would like to know your opinion about an article 
> by Dr.
> Garcia Seara, that includes a number of 70 and some patients for CRT, and
> mentions the favorable response to the implantation of the LV 
> electrode in
> the cases in which the electrical axis is shifted to the left, by 
> placing an
> LV catheter in the anterior region. (revista española de
> cardiologia 2008;61:1245-8)
>
> Dr. Alfredo Cagnolatti
-- 
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee