Cardiology

A Multicenter prospective observational long-term follow up study of endocardial cardiac resynchronization therapy using the Jurdham procedure.

A Multicenter prospective observational long-term follow up study of endocardial cardiac resynchronization therapy using the Jurdham procedure.

Heart Rhythm. 2019 Jul 16;:

Authors: Elencwajg B, López-Cabanillas N, Fischer A, Negrete A, Marin J, Delgado L, Glikson M, Molina L, Worley S, Arnez J, Vidal F, Friedman P, Jurdham Group

Abstract
BACKGROUND: Endocardial cardiac resynchronization therapy (eCRT) avoids the limitations and failures of coronary sinus (CS) resynchronization. However, data regarding long-term outcomes are lacking.
OBJECTIVE: To report the long-term outcome of eCRT performed using the Jurdham procedure in a “real world” setting. METHODS eCRT was performed in patients who failed a CS implant, failed to respond to cardiac resynchronization therapy (CRT), or in selected patients requiring life-long oral anticoagulation. Left Ventricular Ejection Fraction (LVEF), New York Heart Association Functional Class (NYHA FC), and left ventricle (LV) stimulation parameters were assessed during long-term follow up.
RESULTS: From August 2009 to March 2018, the Jurdham Procedure was performed in 88 patients at 15 centers in 8 countries with a follow up (FU) of 32.88 ± 61.52 months (range 0 – 88 months, 196 patient-years). NYHA FC improved from 2.9 pre-implant to 1.3 during FU. LVEF increased <10 percentage points from baseline in 7% of patients, between 10 and 20 percentage points in 11% and >20% in 82% of patients. All-cause mortality at 60 months was 30.5%. There were 3 transient ischemic attacks (TIA) (1.53 per 100 patient-year) and 6 strokes (3.06 per 100 patient-year) of which 4 (66%) had an almost complete recovery.
CONCLUSION: eCRT using the Jurdham Procedure is an effective and safe technique in anticoagulated patients. This approach may be an attractive option for patients with failed CS implants or non-responders to CS CRT. Additionally, it might be a reasonable approach as a first option for patients requiring life-long OAC.

PMID: 31323347 [PubMed – as supplied by publisher]

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