Document Detail


Beneficial effects of biventricular pacing in chronically right ventricular paced patients with mild cardiomyopathy.
MedLine Citation:
PMID:  19966323     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To investigate whether cardiac resynchronization therapy (CRT) by means of biventricular (BiV) pacing can improve left ventricular (LV) function, remodelling and clinical status in chronically right ventricular (RV) paced patients with mild cardiomyopathy. METHODS AND RESULTS: Thirty-six chronically (10 +/- 7 years) RV paced patients with left ventricular ejection fraction (LVEF) < 40% or LVEDD > 55 mm, without an established indication for CRT, were subjected to 6 months RV and BiV pacing in a patient-blinded, randomized crossover design. Treatment-effects of BiV pacing were evaluated for LV function, LV remodelling and clinical status. As compared with RV pacing, BiV pacing significantly improved LV function (LVEF 46 +/- 12 vs. 39 +/- 12% and LVFS 24 +/- 7 vs. 21 +/- 7%) and reduced LV end-diastolic and end-systolic diameters and volumes (LVEDD 56 +/- 8 vs. 59 +/- 8 mm, LVESD 43 +/- 8 vs. 47 +/- 9 mm, LVEDV 132 +/- 65 vs.144 +/- 62 mL and LVESV 77 +/- 56 vs. 92 +/- 55 mL, respectively). In 19 patients (53%) response to BiV pacing was clinically relevant, defined as LVESV reduction >15%. BiV pacing also significantly improved NYHA classification. CONCLUSION: BiV pacing following chronic RV pacing may improve LV function and reverse LV remodelling in patients with relatively mild LV dysfunction or remodelling. Hence, upgrade to BiV pacing might be considered in chronically RV paced patients with mild cardiomyopathy.
Authors:
Irene E van Geldorp; Kevin Vernooy; Tammo Delhaas; Martin H Prins; Harry J Crijns; Frits W Prinzen; Barbara Dijkman
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-12-04
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  12     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-06-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  223-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands. vangeldorp@fys.unimaas.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiac Pacing, Artificial / methods*
Cardiomyopathies / physiopathology,  therapy*
Cross-Over Studies
Defibrillators, Implantable*
Female
Humans
Male
Middle Aged
Single-Blind Method
Stroke Volume / physiology
Ventricular Dysfunction, Left / physiopathology
Ventricular Dysfunction, Right / physiopathology,  therapy*
Ventricular Remodeling / physiology

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


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