Document Detail

Acute hemodynamic benefits of biventricular and single-site systemic ventricular pacing in patients with a systemic right ventricle.
MedLine Citation:
PMID:  23333718     Owner:  NLM     Status:  Publisher    
BACKGROUND: Patients treated by atrial redirection surgery (Senning or Mustard procedure) for transposition of the great arteries (TGA), have an important risk for heart failure caused by dysfunction of the systemic RV. Conventional non-systemic ventricular pacing (non-systVP) may even further increase this risk. OBJECTIVE: We investigated the effects of endocardial non-systVP, biventricular pacing (BiVP), and single-site systemic ventricular pacing (systVP) on systolic cardiac pump function in patients with TGA and status post atrial redirection surgery (SenningMustardTGA). METHODS: During clinically indicated catheterization in 9 patients with SenningMustardTGA, endocardial ventricular stimulation (overdrive DDD-mode, 80-90 bpm) was applied with temporary pacing leads at the non-systemic and the systemic ventricle. Acute changes in dP/dt(max) and systolic pressure of the systemic ventricle, as induced by non-systVP, systVP and BiVP compared to reference, were assessed with a pressure wire within the systemic ventricle. Reference was AAI pacing with similar heart rate (n=7), or non-systVP at a lower heart rate than during stimulation at experimental sites (85 vs. 90 bpm; n=2). RESULTS: Systemic dP/dt(max) and systolic ventricular pressure were significantly higher during systVP (+15.6% and +5.1%, respectively) and BiVP (+14.3% and +4.9%, respectively, compared with non-systVP). In 6 out of 7 patients systemic dP/dt(max) was higher during BiVP and systVP than during AAI pacing. CONCLUSIONS: In a population of patients with SenningMustardTGA, acute hemodynamic effects of endocardial systVP and BiVP were significantly and equally better than those of non-systVP. In some patients systVP and BiVP might even be better than ventricular activation by the intrinsic conduction system.
Irene E van Geldorp; Pierre Bordachar; Joost Lumens; Maxime de Guillebon; Zachary I Whinnett; Frits W Prinzen; Michel Haïssaguerre; Tammo Delhaas; Jean-Benoît Thambo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-17
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier Inc.
Hôpital Cardiologique du Haut-Lévêque, Bordeaux University Hospital, Bordeaux, France; Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands. Electronic address:
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