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Biventricular pacing and heterogeneity of ventricular repolarization in heart failure patients.
MedLine Citation:
PMID:  21977248     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of our study was to evaluate the effect of cardiac resyncronization therapy (CRT) on QT dispersion (QTd), JT dispersion (JTd) and transmural dispersion of re-polarization (TDR), markers of heterogeneity of ventricular repolarization in a study population with severe heart failure.
METHODS AND RESULTS: Fifty patients (43 male, 7 female, aged 60.2 ± 3.1 years) suffering from congestive heart failure (N = 39 NYHA class III; N = 11 NYHA class IV) as a result of coronary artery disease (N = 19) or of dilated cardiomyopathy (N = 31), sinus rhythm, QRS duration >130 ms (mean QRS duration >156 ± 21 ms), an ejection fraction < 35%, left ventricular end-diastolic diameter >55 mm, underwent permanent biventricular DDDR pacemaker implantation. A 12-lead standard electrocardiogram was performed at baseline, during right-, left-, and biventricular pacing and QTd, JTd and TDR were assessed. Biventricular pacing significantly reduced QTd (73.93 ± 19.4 ms during BiVP vs 91 ± 6.7 ms at sinus rhythm, p = 0.004), JTd (73.18 ± 17.16 ms during BiVP vs 100.72 ± 39.04 at baseline p = 0.003), TDR (93.16 ± 15.60 vs 101.55 ± 19.08 at baseline; p<0.004), as compared to sinus rhythm. Right ventricular endocardial pacing and left ventricular epicardial pacing both enhanced QTd (RVendoP 94 ± 51 ms, p<0.03; LVepiP 116 ±71 ms, p<0.02) and TDR (RVendoP 108.13 ± 19.94 ms; p<0.002; LVepiP 114.71 ± 26.1; p<0.05).There was no effect on JTd during right and left ventricular stimulation.
CONCLUSIONS: Biventricular pacing causes a statistically significant reduction of ventricular heterogeneity of ripolarization and has an electrophysiological antiarrhythmic influence on arrhythmogenic substrate of dilatative cardiomiopathy.
Authors:
Lucio Santangelo; Vincenzo Russo; Ernesto Ammendola; Ciro Cavallaro; Filippo Vecchione; Salvatore Garofalo; Antonio D'Onofrio; Nicola Mininni; Raffaele Calabrò
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Publication Detail:
Type:  Journal Article     Date:  2006-05-28
Journal Detail:
Title:  Heart international     Volume:  2     ISSN:  1826-1868     ISO Abbreviation:  Heart Int     Publication Date:  2006  
Date Detail:
Created Date:  2011-10-06     Completed Date:  2011-11-10     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101541778     Medline TA:  Heart Int     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  27     Citation Subset:  -    
Affiliation:
Department of Cardiology, Second University of Naples - Italy.
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