Document Detail

Long-term outcomes in patients with atrioventricular block undergoing septal ventricular lead implantation compared with standard apical pacing.
MedLine Citation:
PMID:  18403387     Owner:  NLM     Status:  MEDLINE    
AIMS: Left ventricular function may be altered by right ventricular apical pacing. The aims of the study were to compare the long-term course of different parameters of left ventricular dysfunction in patients undergoing implantation of a dual-chamber pacemaker with the ventricular lead in a septal position vs. in a standard apical position. METHODS: We randomized 98 patients with atrioventricular block (AV-block) undergoing pacemaker implantation to positioning the ventricular lead in the high or mid septum (n = 53) or in the apex (n = 45) of the right ventricle. N-terminal pro-brain natriuetic peptide (BNP) levels, left ventricular ejection fraction (LVEF), and exercise capacity were analysed 3 days, 3 months, and 18 months after the implantation. The primary endpoints were the changes of these parameters from baseline to 18 months. RESULTS: Changes of BNP levels, LVEF, and exercise capacity from baseline to 18 months were statistically not different between septal and apical stimulation. The clinical occurrence or deterioration of overt heart failure was similar in both treatment arms. CONCLUSION: With regard to different parameters of congestive heart failure, a septal stimulation site is not superior to conventional apical pacing in unselected patients undergoing pacemaker implantation for AV-block.
Alexander Kypta; Clemens Steinwender; Jürgen Kammler; Franz Leisch; Robert Hofmann
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2008-04-10
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:  10     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-29     Completed Date:  2008-05-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  574-9     Citation Subset:  IM    
First Department of Internal Medicine, Cardiovascular Division, Academic Teaching and General Hospital Linz, Krankenhausstrasse 9, A-4020 Linz, Austria.
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MeSH Terms
Atrioventricular Block / diagnosis*,  prevention & control*
Cardiac Pacing, Artificial / methods*
Electrodes, Implanted*
Heart Septum*
Heart Ventricles*
Longitudinal Studies
Prosthesis Implantation / methods*
Treatment Outcome
Comment In:
Europace. 2008 May;10(5):572-3   [PMID:  18403386 ]

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