Pacing therapies for congestive heart failure considering the results of the PATH-CHF-study

Optimized uni- or biventricular pacing therapy improves left ventricular fu nction in 80 % of patients (responders) with wide QRS in surface EGG. Immed iate improvement could be shown by an increase of LV dP/dt up to 28 % and a ortic pulse pressure up to 16 %. Chronic improvement was documented by prol ongation of the 6-minute-walk-test by 60 meters, an improvement of O-2 upta ke by 23 % at exercise, and improvement of quality of life score and NYHA c lassification. This controlled study has shown for the first time a signifi cant clinical improvement of congestive heart failure by pacing therapy in a selected group of patients. Conventional right ventricular stimulation is insufficient in this group of patients characterized by LBBB. These result s support the hypothesis that optimized ventricular stimulation is an effec tive chronic therapy of congestive heart failure by improvement of left ven tricular hemodynamics. Epicardial placement of the left ventricular electro des in 50 patients was possible without operative and with low (2 %) early mortality.