Document Detail

Acute effects of dual-chamber pacing on the left ventricular systolic function and relaxation in patients with advanced AV block and sick sinus syndrome.
MedLine Citation:
PMID:  16447924     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Abnormal activation of the ventricles via right ventricular apical pacing deteriorates cardiac function, which may explain the increased mortality of patients with congestive heart failure receiving permanent pacemakers. We hypothesized that pacing at alternative sites may cause less detrimental effects on the cardiac function. METHODS: Five symptomatic patients with either advanced AV block (n = 4) or sick sinus syndrome with normal left ventricular (LV) function (n = 1) were studied. During cardiac catheterization, LV pressure was recorded with a high-fidelity catheter-tipped transducer. Baseline rhythms were sinus rhythm or VVI pacing. Sequential VDD pacing with variable AV intervals was performed at the right ventricular apex (RVA), right ventricular septum (RVS), right ventricular outflow tract (RVOT) and coronary sinus (CS). LV systolic function was assessed by calculating dP/dt(max) and LV diastolic function was indexed by calculating the exponential isovolumic relaxation constant (Tau). Percentage changes (mean +/- SE) from baseline to pacing were measured. RESULTS: RVA pacing reduced dP/dt(max) (-0.8 +/- 8.4%) and prolonged Tau (7.0 +/- 5.6%); RVS pacing enhanced dP/dt(max) (20.7 +/- 15.3%) and shortened Tau (-10.4 +/- 9%); RVOT pacing reduced dP/dt(max) (-8.0 +/- 20.0%) and shortened Tau (-6.0 +/- 12.2%); CS pacing reduced dP/dt(max) (-11.7 +/- 13.0%) and prolonged Tau (10.5 +/- 11.9%). Our results demonstrated that different pacing sites have different effects on LV contractility and relaxation in patients with normal LV function. CONCLUSION: Since pacing at the RVS preferably increased LV dP/dt(max) and shortened Tau, it may be a better alternative than the RVA.
Hsiang-Chiang Hsiao; Chen-Huan Chen; Chi-Woon Kong; Chun-Peng Liuln
Related Documents :
3976504 - Acute hemodynamic and antiischemic effects of intravenous amiodarone.
11220534 - The north american experience with the ablate and pace trial (apt) for medically refrac...
4008774 - Noninvasive assessment of pacemaker hemodynamics by doppler echocardiography: importanc...
2031424 - Phase image analysis in wolff-parkinson-white syndrome. role of transesophageal pacing.
8315624 - Coronary care follow-up study: acute care required immediately following thrombolytic t...
1595764 - Excluding heart disease in the patient with chest pain.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Chinese Medical Association : JCMA     Volume:  69     ISSN:  1726-4901     ISO Abbreviation:  J Chin Med Assoc     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-02-01     Completed Date:  2006-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101174817     Medline TA:  J Chin Med Assoc     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  32-6     Citation Subset:  IM    
Division of Cardiology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Cardiac Pacing, Artificial*
Heart Block / physiopathology,  therapy*
Sick Sinus Syndrome / physiopathology,  therapy*
Ventricular Function, Left*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Comparison of plain MRI and MR arthrography in the evaluation of lateral ligamentous injury of the a...
Next Document:  Intrathoracic paraspinal malignant peripheral nerve sheath tumor.