The Green Lane and Auckland City Hospital cardiac resynchronisation therapy experience.

AIM

To evaluate the outcome of cardiac resynchronisation therapy (CRT) in Auckland since its inception in 2000. Outcome measures were periprocedural events including procedure duration, fluoroscopic time, procedure success, complications, and echocardiographic markers of response.

METHODS

Retrospective review of those undergoing CRT implantation at Green Lane and Auckland City Hospitals.

RESULTS

159 CRT procedures were performed on 139 patients between 2000 and April 2011. Of all procedures: 63% had new device implants, and 23% were upgraded from a pacemaker or defibrillator to CRT. Mean age 62 years, 77% male, mean left ventricular ejection fraction (LVEF) 25%, mean QRS duration 175 ms, 91% LBBB, 36% ischaemic cardiomyopathy. Mean procedure time 147 min and fluoroscopy time 30 min. Eight patients had significant periprocedural complications (6%), 17 experienced lead displacement (12%), and 15 (11%) had unsuccessful procedures. 46% of patients had complete echocardiographic data, of these LVEF improved by >5% in 52%, and decreased by >5% in 6% over a 16-month follow-up.

CONCLUSIONS

Our service performs well with respect to complication rate, though less well when failure of implantation and lead dislodgement are considered. Where complete echocardiographic data was present 52% of our patients derived significant improvement in LVEF.