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Targeting Left Ventricular Lead Placement to Improve Cardiac Resynchronization Therapy Outcomes

  • Invasive Electrophysiology and Pacing (J Singh, Section Editor)
  • Published:
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Abstract

Although cardiac resynchronization therapy (CRT) has been established as an important treatment modality for heart failure patients, at least one third of CRT recipients do not respond to this therapy or derive minimal benefit from it. The impact of the site of left ventricular (LV) pacing on outcome after CRT has been examined extensively. Initial studies suggested benefit of posterior or lateral sites but subsequent work has yielded conflicting results. There also remain conflicting results of apical vs basal pacing sites. Avoiding LV lead placement at sites of transmural scar is however a viable strategy. In addition, The TARGET and STARTER trials, 2 independent, randomized, prospective studies, have demonstrated that targeting LV lead placement to sites of latest LV mechanical activation as defined by speckle tracking echocardiography remains the most promising method to improve clinical outcome after CRT.

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Conflict of Interest

Jeffrey Liu declares that he has no conflict of interest.

Evan Adelstein has received research support from St. Jude Medical.

Samir Saba has received research funding from Medtronic Inc., Boston Scientific Inc., and St. Jude Medical. He also received intellectual property rights from Medtronic Inc. He has also been a consultant for Spectranetics Inc.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Heart and Vascular Institute, University of Pittsburgh Medical Center, University of Pittsburgh, 200 Lothrop St, PUH B535, Pittsburgh, PA, 15213, USA

    Jeffrey Liu, Evan Adelstein & Samir Saba

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  1. Jeffrey Liu
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  2. Evan Adelstein
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  3. Samir Saba
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Correspondence to Samir Saba.

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This article is part of the Topical Collection on Invasive Electrophysiology and Pacing

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Liu, J., Adelstein, E. & Saba, S. Targeting Left Ventricular Lead Placement to Improve Cardiac Resynchronization Therapy Outcomes. Curr Cardiol Rep 15, 390 (2013). https://doi.org/10.1007/s11886-013-0390-2

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  • DOI: https://doi.org/10.1007/s11886-013-0390-2

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