Short summary

This study aims to clarify if a new method of left ventricular pacemaker lead implantation (interventional CRT: I-CRT) in patients with heart failure is better than conventional technique (traditional CRT: T-CRT). The study is a retrospective cohort study based on data from the Danish Pacemaker and ICD Register, patient record files and fluoroscopy analyses. 1142 patients with heart failure who received CRT during 01/01/12-31/08/18 at Odense University Hospital will be included.

Rationale

Treatment of patients with heart failure relies on medical treatment and invasive treatment. Some patients receiving optimal medical treatment (OMT) do not obtain a clinically sufficient response. Therefore, some of these patients are eligible for cardiac resynchronization therapy (CRT), also known as biventricular pacing. CRT is an important treatment of patients with heart failure and reduced ejection fraction.

It has been estimated that 30-40% of patients eligible for CRT do not respond to the treatment or even experience a clinical deterioration. Placement of the left ventricular pacing lead (LVL) in one of the side branches of the coronary sinus is an important factor for obtaining greater clinical outcomes. Placement of the LVL may cause difficulties during the implantation procedure. Therefore, a new method, the so-called I-CRT, has been developed to overcome these difficulties hereby optimizing LVL placement. I-CRT is not performed in many hospitals since the procedure sometimes can be complicated. Despite a more complicated procedure I-CRT contributes with new possibilities to the traditional implantation procedure, T-CRT. Comparing data from the two patients groups (I-CRT vs. T-CRT) could help clarify if patients receiving I-CRT achieves greater clinical outcomes compared to patients receiving T-CRT.

Description of the cohort

1142 patients with clinical heart failure who received T-CRT or I-CRT during the period: 01/01/2012-31/08/2018 at Odense University Hospital. First time implants as well as upgrades will be included.