Document Detail

Left ventricular function during and after right ventricular pacing.
MedLine Citation:
PMID:  15519023     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of this research was to evaluate right ventricular pacing effects on left ventricular function. BACKGROUND: Right ventricular pacing alters the ventricular activation sequence and reduces left ventricular ejection fraction (EF). It is unclear whether the observed reduction in EF can be completely attributed to the alteration in activation sequence. METHODS: Twelve subjects (eight women), mean age 68 +/- 12 years, with transvenous dual-chamber pacemakers, normal left ventricular function, and intact atrioventricular (AV) conduction were studied with serial-gated blood pool studies. Left ventricular EF was measured at a fixed rate after at least 1 week of atrial pacing only (baseline), during short-term (2 h) and mid-term (1 week) AV sequential pacing with a short AV delay, and after short- and mid-term AV pacing. RESULTS: Baseline EF was 66.5 +/- 4.5%. Short-term AV pacing resulted in a decrease in EF to 60.3 +/- 5.2% (p < 0.0002). After one week of AV pacing, there was a further decline in EF to 52.9 +/- 8.3% (p < 0.0001). After cessation of mid-term pacing, EF was 57.3 +/- 5.9% (p < 0.0001 vs. baseline). A total of 2, 5, 8, and 24 h later, EF remained depressed (59% to 60%, p < 0.007). At 32 h, EF was 62.9 +/- 7.6% (p < 0.11 compared with baseline). CONCLUSIONS: The abnormal activation sequence resulting from right ventricular pacing accounts for only part of the reduction in EF as mid-term pacing is associated with a lower EF than short-term pacing, and EF remains depressed after cessation of AV pacing. Changes in ventricular function induced by right ventricular pacing may account for some of its associated adverse effects.
Maher Nahlawi; Michael Waligora; Stewart M Spies; Robert O Bonow; Alan H Kadish; Jeffrey J Goldberger
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  44     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-02     Completed Date:  2005-01-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1883-8     Citation Subset:  AIM; IM    
Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois, USA.
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MeSH Terms
Aged, 80 and over
Biological Markers / blood
Cardiac Pacing, Artificial*
Catecholamines / blood
Follow-Up Studies
Heart Conduction System / metabolism,  physiopathology,  surgery
Heart Ventricles / metabolism,  physiopathology
Middle Aged
Pacemaker, Artificial
Recovery of Function / physiology
Sick Sinus Syndrome / blood,  physiopathology,  therapy
Stroke Volume / physiology
Time Factors
Treatment Outcome
Ventricular Function, Left / physiology*
Grant Support
Reg. No./Substance:
0/Biological Markers; 0/Catecholamines
Comment In:
J Am Coll Cardiol. 2004 Nov 2;44(9):1889-90   [PMID:  15519024 ]

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