Document Detail


Myocardial scintigraphy after pacemaker implantation for congenital complete atrioventricular block.
MedLine Citation:
PMID:  17345095     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with isolated congenital complete atrioventricular block (CCAVB) occasionally develop dilated cardiomyopathy (DCM), despite early pacemaker implantation. However, the etiology of the DCM and its relationship to permanent ventricular pacing are not fully understood. Twenty-five patients with CCAVB underwent (99m) technetium (Tc) myocardial perfusion scintigraphy. Five patients were studied before and after pacing, providing a total of 30 image sets, which were divided into three groups; group 1: CCAVB before pacemaker implantation (PMI) (n = 11); group 2: CCAVB after PMI who did not subsequently develop DCM (n = 13); group 3: CCAVB after PMI who subsequently developed DCM (n = 6). Perfusion defects on single-photon-emission computed tomography (SPECT) were identified in group 1, 0 of 11 patients; group 2, 85% of patients; and group 3, 100% of patients. In groups 2 and 3, in patients with right ventricular pacing, the perfusion defects were mainly in the septum or between the apex and septum. On 20 segments' polar maps, the distribution of %uptake showed a similar pattern in groups 2 and 3, the degree of decreased %uptake and the number of segments with decreased %uptake being more severe in group 3. "Artificial" left bundle branch block (LBBB) pattern myocardial contraction induced by right ventricular pacing decreased myocardial perfusion around the apex and septum. Some patients with CCAVB will develop left ventricular dysfunction caused by artificial LBBB-induced interventricular asynchrony.
Authors:
Hisashi Takasugi; Ken Watanabe; Yasuo Ono; Heima Sakaguchi; Noriko Motoki; Yoko Yoshida; Shigeyuki Echigo; Kazuki Fukuchi; Yoshio Ishida
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Publication Detail:
Type:  Journal Article     Date:  2007-03-08
Journal Detail:
Title:  European journal of pediatrics     Volume:  167     ISSN:  1432-1076     ISO Abbreviation:  Eur. J. Pediatr.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-05-22     Revised Date:  2008-06-05    
Medline Journal Info:
Nlm Unique ID:  7603873     Medline TA:  Eur J Pediatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  183-8     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, National Cardiovascular Center, Suita, Osaka, Japan. takasugi@kochi-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Atrioventricular Block / physiopathology,  radionuclide imaging,  therapy*
Child
Child, Preschool
Coronary Circulation
Female
Gated Blood-Pool Imaging
Heart / radionuclide imaging*
Humans
Infant
Male
Myocardial Contraction
Myocardium / metabolism*
Organophosphorus Compounds / pharmacokinetics
Organotechnetium Compounds / pharmacokinetics
Pacemaker, Artificial*
Stroke Volume
Tomography, Emission-Computed, Single-Photon
Chemical
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane

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