Document Detail


Minimizing right ventricular pacing in patients with sinus node disease and prolonged PQ interval: the impact on exercise capacity.
MedLine Citation:
PMID:  24846513     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Several clinical and experimental studies have shown that unnecessary right ventricular pacing in sinus node disease can be detrimental. Inter- and intraventricular asynchrony imposed by right ventricular pacing may cause reduction in contractility and relaxation of left ventricle, worsening mitral regurgitation, regional redistribution of myocardial perfusion and oxygen consumption, and asymmetrical hypertrophy of left ventricular wall. In some patients sinus node disease coexists with impaired atrioventricular conduction. The optimal pacing mode in this population is not determined. Minimizing right ventricular pacing can preserve inter- and intraventricular synchrony. On the other hand longer atrioventricular delay may cause atrioventricular asynchrony. The aim of this study was to prospectively assess the impact of minimizing right ventricular pacing in patients with DDD pacemaker implanted for sinus node disease and prolonged PQ interval on exercise capacity, cardiac function and quality of life.
METHODS: The study enrolled 50 consecutive patients with prolonged PQ interval who were implanted with DDD pacemaker because of sinus node disease. Each patient was treated alternately with two pacing modes in random order for 4-months periods: conventional dual-chamber pacing and dual-chamber minimal ventricular pacing (prolonged atrioventricular delay). At the end of each phase the following tests were performed: cardiopulmonary exercise testing, echocardiographic evaluation and quality of life assessment (SF36).
RESULTS: There was no significant relationship between pacing mode and cardiopulmonary parameters, echocardiographic parameters and quality of life.
CONCLUSIONS: Sequential atrioventricular pacing may be a reasonable choice for treating patients with sinus node disease and prolonged PQ interval.
Authors:
Krystian Krzyżanowski; Dariusz Michałkiewicz; Zbigniew Orski; Robert Wierzbowski; Robert Ryczek; Andrzej Cwetsch
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-20
Journal Detail:
Title:  Cardiology journal     Volume:  -     ISSN:  1897-5593     ISO Abbreviation:  Cardiol J     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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