Document Detail


Biventricular versus conventional right ventricular stimulation for patients with standard pacing indication and left ventricular dysfunction: the Homburg Biventricular Pacing Evaluation (HOBIPACE).
MedLine Citation:
PMID:  16697307     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The Homburg Biventricular Pacing Evaluation (HOBIPACE) is the first randomized controlled study that compares the biventricular (BV) pacing approach with conventional right ventricular (RV) pacing in patients with left ventricular (LV) dysfunction and a standard indication for antibradycardia pacing in the ventricle. BACKGROUND: In patients with LV dysfunction and atrioventricular block, conventional RV pacing may yield a detrimental effect on LV function. METHODS: Thirty patients with standard indication for permanent ventricular pacing and LV dysfunction defined by an LV end-diastolic diameter > or =60 mm and an ejection fraction < or =40% were included. Using a prospective, randomized crossover design, three months of RV pacing were compared with three months of BV pacing with regard to LV function, N-terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentration, exercise capacity, and quality of life. RESULTS: When compared with RV pacing, BV stimulation reduced LV end-diastolic (-9.0%, p = 0.022) and end-systolic volumes (-16.9%, p < 0.001), NT-proBNP level (-31.0%, p < 0.002), and the Minnesota Living with Heart Failure score (-18.9%, p = 0.01). Left ventricular ejection fraction (+22.1%), peak oxygen consumption (+12.0%), oxygen uptake at the ventilatory threshold (+12.5%), and peak circulatory power (+21.0%) were higher (p < 0.0002) with BV pacing. The benefit of BV over RV pacing was similar for patients with (n = 9) and without (n = 21) atrial fibrillation. Right ventricular function was not affected by BV pacing. CONCLUSIONS: In patients with LV dysfunction who need permanent ventricular pacing support, BV stimulation is superior to conventional RV pacing with regard to LV function, quality of life, and maximal as well as submaximal exercise capacity.
Authors:
Michael Kindermann; Benno Hennen; Jens Jung; Jürgen Geisel; Michael Böhm; Gerd Fröhlig
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2006-04-24
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  47     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-15     Completed Date:  2006-05-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1927-37     Citation Subset:  AIM; IM    
Affiliation:
Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany. Michael.Kindermann@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Arrhythmias, Cardiac / complications,  therapy*
Atrial Fibrillation / therapy
Bradycardia / therapy
Cardiac Pacing, Artificial / methods*
Cardiovascular Agents / therapeutic use
Combined Modality Therapy
Cross-Over Studies
Exercise Tolerance
Female
Heart Block / therapy
Heart Failure / therapy
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Peptide Fragments / blood
Prospective Studies
Quality of Life
Single-Blind Method
Stroke Volume
Ventricular Dysfunction, Left / complications,  therapy*
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2006 May 16;47(10):1946-8   [PMID:  16697309 ]

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


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