Abstracts: ASAIO Cardiac Abstracts
CABG AND BI VENTRICULAR PACING: DO PAST TRIALS DICTATE A CHANGE IN FUTURE PRACTICE?
Cardiac resynchronization therapy (CRT) is beneficial for select heart failure patients. Placement of epicardial LV leads during CABG may be performed with ease and reduced cost. A review of the MIRACLE ICD trial was performed to determine the response to CRT in patients with history of CABG.
The data from all 555 randomized patients with NYHA class III/IV symptoms, EF ≤ 35%, QRS ≥ 130ms, and indication for ICD was analyzed. A subgroup analysis from 363 patients with ischemic heart disease revealed 222 (61%) with previous history of CABG. Mean age 69 years, 92% male, time from CABG to implant 9.2 years, 3.5 avg. vessels bypassed, EF 21.5% and NYHA class 2.8. Student’s t-test is used to compare outcomes for patients randomized to CRT versus no pacing for six months.
Many with previous history of CABG demonstrate improved quality of life, functional status and exercise capacity with CRT. Patients undergoing CABG, who meet the criteria for CRT, may benefit from epicardial LV lead placement at the time of operation.Copyright © 2005 by the American Society for Artificial Internal Organs