Echocardiography Aids Selection of Pacemaker Candidates

Their study was presented at the annual congress of the European Society of Cardiology in Berlin (Germany).


Currently, based on electrocardiogram (ECG) parameters, 30% of heart failure patients treated with the new pacing technology do not benefit from this expensive therapy. To remedy this, the researchers studied 25 patients with end-stage heart failure who were scheduled for implantation of a resynchronization device. During their study, the day before and after implantation, four echocardiographic parameters were assessed, and cardiac performance was evaluated by measuring the left ventricular ejection fraction (LVEF). The LVEF improved > 5% in 17 patients but did not improve in the remaining eight patients.

The only echocardiographic parameter that correlated with the gain in LVEF was the septal to lateral delay before implantation. Therefore, the researchers concluded that heart failure patients with a long (60 ms) septal to lateral delay are likely to benefit from resynchronization therapy, and this parameter can be applied to predict with a high degree of sensitivity and specificity which patients may benefit from the therapy.

The researchers conclude that this is an easy and economical way to screen potential candidates for the therapy. However, they caution that larger trials are necessary to confirm their results. The research, led by Dr. Sander G. Molhoek, was conducted at Leiden University Medical Center (The Netherlands).




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