Document Detail

Adverse effects of atrioventricular synchronous right ventricular pacing on left ventricular sympathetic activity, efficiency, and hemodynamic status.
MedLine Citation:
PMID:  16731648     Owner:  NLM     Status:  MEDLINE    
Right ventricular (RV) pacing is now recognized to play a role in the development of heart failure in patients with and without underlying left ventricular (LV) dysfunction. We used the cardiac norepinephrine spillover method to test the hypothesis that RV pacing is associated with cardiac sympathetic activation. We studied 8 patients with normal LV function using temporary right atrial and ventricular pacing wires. All measurements were carried out during a fixed atrial pacing rate. The radiotracer norepinephrine spillover technique was employed to measure total body and cardiac sympathetic activity while changes in LV performance were evaluated with a high-fidelity manometer catheter. Atrioventricular synchronous RV pacing, compared with atrial pacing alone, was associated with a 65% increase in cardiac norepinephrine spillover, an increase in LV end-diastolic pressure, and a reduction in myocardial efficiency. These responses may play a role in the development of heart failure and poor outcomes that are associated with chronic RV pacing.
Abdul Al-Hesayen; John D Parker
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-05-26
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  291     ISSN:  0363-6135     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-10     Completed Date:  2007-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H2377-9     Citation Subset:  IM    
Dept. of Medicine, Division of Cardiology, Mount Sinai and Univ. Health Network Hospitals, Univ. of Toronto, 600 Univ. Ave., Suite 1609, Toronto, Ontario, Canada.
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MeSH Terms
Atrioventricular Node / drug effects,  physiopathology*
Cardiac Pacing, Artificial / adverse effects*
Heart Catheterization
Heart Ventricles / innervation,  physiopathology*
Middle Aged
Norepinephrine / metabolism
Sympathetic Nervous System / drug effects,  physiopathology*
Ventricular Function, Left / physiology
Reg. No./Substance:

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