| Permanent direct his bundle pacing does not induce ventricular dyssynchrony unlike conventional right ventricular apical pacing. An intrapatient acute comparison study. | |
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MedLine Citation:
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PMID: 17115267 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Benefits of A-V synchrony during right ventricular apical pacing are neutralized by induction of ventricular dyssynchrony. Only a few data are reported about direct His bundle pacing influence on ventricular synchronism. AIM: Was to assess the capability of direct His bundle pacing to prevent pacing-induced ventricular dyssynchrony comparing DDD- (or VVI- in case of Atrial Fibrillation) right ventricular apical pacing with DDD- (or VVI-) direct His bundle pacing in the same patients cohort. METHODS: 23 of 24 patients (mean age 75.1 +/- 6.4 years) with narrow QRS (HV < 65 ms) underwent permanent direct His bundle pacing for "brady-tachy syndrome" (11) or supra-Hisian II/III-degree AV Block (permanent atrial fibrillation 7, AV Node ablation 1). A 4.1 F screw-in lead was fixed in His position, guided by endocardial pacemapping and unipolar recordings. Additional permanent (13 patients) or temporary right ventricular apical pacing leads were also positioned. Inter- and left intra-ventricular dyssynchrony, mitral regurgitation and left systolic ventricular function Tei index were assessed during either direct His bundle pacing or right ventricular apical pacing. RESULTS: Permanent direct His bundle pacing was obtained in 23 of 24 patients. Indexes of ventricular dyssynchrony were drastically reduced, mitral regurgitation decreased and left systolic ventricular function Tei index improved during direct His bundle pacing (or His bundle and septum pacing) in comparison to apical pacing (p < 0.05). No statistically significant differences were observed between direct His bundle pacing and combined His bundle and septum pacing. CONCLUSION: Direct His bundle pacing (also fused with adjacent septum capture) prevents pacing-induced ventricular dyssynchrony. |
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Authors:
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Domenico Catanzariti; Massimiliano Maines; Claudio Cemin; Gianpaolo Broso; Tiziana Marotta; Giuseppe Vergara |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2006-11-18 |
Journal Detail:
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Title: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing Volume: 16 ISSN: 1383-875X ISO Abbreviation: J Interv Card Electrophysiol Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-12-07 Completed Date: 2007-05-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9708966 Medline TA: J Interv Card Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 81-92 Citation Subset: IM |
Affiliation:
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Divisione di Cardiologia, Ospedale S. Maria del Carmine, Corso Verona, n. 4, 38068, Rovereto, TN, Italy. domenico.catanzariti@apss.tn.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bundle of His* Cardiac Pacing, Artificial* / adverse effects, standards Echocardiography, Doppler Electrocardiography Electrodes, Implanted* Electrophysiologic Techniques, Cardiac Female Heart Block / therapy*, ultrasonography Humans Male Mitral Valve Insufficiency / ultrasonography Postoperative Complications / prevention & control Sick Sinus Syndrome / therapy*, ultrasonography Systole Ventricular Function, Left* Ventricular Function, Right |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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