Document Detail


Impact of temporary right ventricular pacing from different sites on echocardiographic indices of cardiac function.
MedLine Citation:
PMID:  21764814     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims To assess the impact of pacing from different right ventricular (RV) pacing sites on left ventricular (LV) function. Chronic apical RV pacing may induce heart failure. To reduce this RV, mid-septum and outflow tract are suggested as alternative pacing sites. We therefore assessed cardiac performance during temporary RV pacing from apical vs. mid-septum or outflow tract sites, using echocardiography and electrocardiography. Methods and results Patients scheduled for a permanent pacemaker underwent temporary pacing in dual-chamber mode (DDD) and with atrio-ventricular delay optimized. The ventricular lead was moved to either the RV apex, mid-septum or outflow tract. Comprehensive echocardiography was performed in each position. Twenty-two patients completed the study. The baseline data was collected at atrial pacing mode (AAI). QRS duration lengthened with RV apical pacing (97 ± 22 ms AAI vs. 154 ± 18 ms RV apical, P< 0.001) and shortened with mid-septum or outflow tract pacing (147 ± 14 ms RV mid-septum and 136 ± 16 ms RV outflow tract, P= 0.001 and P< 0.001, respectively, vs. RV apical). Right ventricular apical pacing was associated with reductions in stroke volume and LV ejection fraction (54 ± 6% AAI vs. 48 ± 5% RV apical, P= 0.001). Right ventricular mid-septum (52 ± 5%) and outflow tract (54 ± 6%) pacing improved LV ejection fraction in comparison with apical pacing (P< 0.01 for both). Pacing at all sites induced dyssynchrony. In comparison with RV apical pacing dyssynchrony was reduced by mid-septum or outflow tract pacing. Conclusions Right ventricular pacing at the mid-septum or outflow tract results in narrower QRS complexes, less dyssynchrony, and better LV systolic function than RV apical pacing.
Authors:
M Hafez A Alhous; Gary R Small; Andrew Hannah; Graham S Hillis; Paul Broadhurst
Related Documents :
9547004 - Ultrastructural evidence for the formation of amyloid fibrils within cardiomyocytes in ...
12360154 - Rationale and design of a study assessing treatment strategies of atrial fibrillation i...
1708044 - Mode of action of a new class ic drug (org 7797) against atrial fibrillation in conscio...
3336964 - Clinical and electrophysiologic effects of amiodarone in patients with atrial fibrillat...
18599494 - Decreasing incidence of critical limb ischemia after intra-aortic balloon pump counterp...
9033334 - Ecmo and inhaled nitric oxide for cardiopulmonary failure after heart retransplantation.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-14
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:  -     ISSN:  1532-2092     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Cardiology, Aberdeen Royal Infirmary/University of Aberdeen, Aberdeen, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Use of variability in national and regional data to estimate the prevalence of lymphangioleiomyomato...
Next Document:  Actions elicited during scheduled and unscheduled in-hospital follow-up of cardiac devices: results ...