Is there a need for more than one left ventricular lead in some patients?

• Published in: Europace (London, England) Vol. 11 Suppl 5; no. Supplement 5; pp. v29 - v31
• Main Authors: Sanaa, Islem, Franceschi, Frédéric, Prévôt, Sébastien, Bastard, Emilie, Deharo, Jean-Claude
• Format: Journal Article
• Language: English
• Published: England 01.11.2009
• Subjects: Cardiac Pacing, Artificial - methods; Electrodes, Implanted; Humans; Myocardial Contraction - physiology; Pacemaker, Artificial; Ventricular Dysfunction, Left - physiopathology; Ventricular Dysfunction, Left - therapy; Ventricular Remodeling - physiology
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/eup279

Cardiac resynchronization therapy (CRT) is an effective treatment of heart failure in selected patients. However, with conventional CRT, notable left ventricular (LV) reverse remodelling is achieved in only 60-70% of patients. This lack of effect of CRT might be due to incomplete resynchronization. In some patients, the paced activation front arising from a single LV electrode is unfavourable, possibly resulting in suboptimal resynchronization. Dual-site LV CRT has theoretical advantages in faster and more physiological LV activation. Some clinical evidence supports dual LV pacing. Nevertheless, a clear benefit of this pacing modality in patients chronically implanted is still unproved. A randomized study comparing single- and dual-site LV pacing, the Triple-Site Cardiac Resynchronization study of Patients with Heart Failure (TRUST CRT) is still ongoing.