| Biventricular stimulation improves right and left ventricular function after tetralogy of Fallot repair: acute animal and clinical studies. | |
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MedLine Citation:
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PMID: 20185107 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Optimal treatment of right ventricular (RV) dysfunction observed in patients after tetralogy of Fallot (TOF) repair is unclear. Studies of biventricular (BiV) stimulation in patients with congenital heart disease have been retrospective or have included patients with heterogeneous disorders. OBJECTIVE: The purpose of this study was to determine the effects on cardiac function of stimulating at various cardiac sites in an animal model of RV dysfunction and dyssynchrony and in eight symptomatic adults with repaired TOF. METHODS: Pulmonary stenosis and regurgitation as well as RV scars were induced in 15 piglets to mimic repaired TOF. The hemodynamic effects of various configurations of RV and BiV stimulation were compared with sinus rhythm (SR) 4 months after surgery. In eight adults with repaired TOF, RV and left ventricular (LV) dP/dt(max) were measured invasively during SR, apical RV stimulation, and BiV stimulation. RESULTS: At 4 months, RV dilation, dysfunction, and dyssynchrony were present in all piglets. RV stimulation caused a decrease in LV function but no change in RV function. In contrast, BiV stimulation significantly improved LV and RV function (P < .05). Echocardiography and epicardial electrical mapping showed activation consistent with right bundle branch block during SR and marked resynchronization during BiV stimulation. In patients with repaired TOF, BiV stimulation increased significantly RV and LV dP/dt(max) (P < .05). CONCLUSION: In this swine model of RV dysfunction and in adults with repaired TOF, BiV stimulation significantly improved RV and LV function by alleviating electromechanical dyssynchrony. |
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Authors:
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Jean-Benoit Thambo; Pierre Dos Santos; Maxime De Guillebon; Francois Roubertie; Louis Labrousse; Frederic Sacher; Xavier Iriart; Stephane Lafitte; Sylvain Ploux; Pierre Jais; Xavier Roques; Michel Haissaguerre; Philippe Ritter; Jacques Clementy; Sanjiv M Narayan; Pierre Bordachar |
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Publication Detail:
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Type: Journal Article Date: 2009-11-20 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 7 ISSN: 1556-3871 ISO Abbreviation: Heart Rhythm Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-02-26 Completed Date: 2010-06-01 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 344-50 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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University Hospital of Bordeaux, Bordeaux, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Animals Cardiac Pacing, Artificial* Disease Models, Animal Humans Swine Tetralogy of Fallot / physiopathology, surgery* Ventricular Dysfunction, Right / physiopathology, therapy* Ventricular Function, Left Ventricular Function, Right |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL083359-01A1/HL/NHLBI NIH HHS; R01 HL083359-04/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
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Heart Rhythm. 2010 Mar;7(3):351-2
[PMID:
20185108
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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