Image-guided left ventricular lead placement in cardiac resynchronization therapy for patients with heart failure: a meta-analysis

BMC Cardiovascular Disorders

Research Article

Jia-liang Mao¹  Yan Jin¹  Qi Zhang¹  Ben He¹ 

[1] Department of Cardiology, Ren Ji hospital, School of Medicine, Shanghai Jiao Tong University, 200001, Shanghai, China;

关键词: Cardiac resynchronization therapy;    Heart failure;    Echocardiography;    Image-guided;    Echocardiography guided;   

DOI  :  10.1186/s12872-015-0034-0

 received in 2015-01-19, accepted in 2015-04-21,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundHeart failure (HF) is a debilitating condition that affects millions of people worldwide. One means of treating HF is cardiac resynchronization therapy (CRT). Recently, several studies have examined the use of echocardiography (ECHO) in the optimization of left ventricular (LV) lead placement to increase the response to CRT. The objective of this study was to synthesize the available data on the comparative efficacy of image-guided and standard CRT.MethodsWe searched the PubMed, Cochrane, Embase, and ISI Web of Knowledge databases through April 2014 with the following combinations of search terms: left ventricular lead placement, cardiac resynchronization therapy, image-guided, and echocardiography-guided. Studies meeting all of the inclusion criteria and none of the exclusion criteria were eligible for inclusion. The primary outcome measures were CRT response rate, change in LV ejection fraction (LVEF), and change in LV end systolic volume (LVESV). Secondary outcomes included the rates of all-cause mortality and HF-related hospitalization.ResultsOur search identified 103 articles, 3 of which were included in the analysis. In total, 270 patients were randomized to the image-guided CRT and 241, to the standard CRT. The pooled estimates showed a significant benefit for image-guided CRT (CRT response: OR, 2.098, 95 % CI, 1.432–3.072; LVEF: difference in means, 3.457, 95 % CI, 1.910–5.005; LVESV: difference in means, −20.36, 95 % CI, −27.819 – −12.902).ConclusionsImage-guided CRT produced significantly better clinical outcomes than the standard CRT. Additional trials are warranted to validate the use of imaging in the prospective optimization of CRT.

【 授权许可】

Unknown   
© Jin et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.