Document Detail


Right ventricular outflow tract pacing causes intraventricular dyssynchrony in patients with sick sinus syndrome: a real-time three-dimensional echocardiographic study.
MedLine Citation:
PMID:  20399607     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The optimal right ventricular pacing site remains controversial. The aim of this study was to assess how acute right ventricular outflow tract (RVOT) pacing affects global left ventricular function and intraventricular dyssynchrony of the left ventricle. METHODS: Thirty-six patients with sick sinus syndrome and intact intrinsic atrioventricular conduction were enrolled. All patients underwent dual-chamber permanent pacemaker implantation, with the atrial lead placed in the right atrial appendage and the right ventricle lead positioned at the septal site of the RVOT. Chamber size, dyssynchrony index, myocardial performance index, and global left ventricular ejection fraction were determined using transthoracic two-dimensional echocardiography, tissue Doppler echocardiography, and real-time three-dimensional echocardiography. RESULTS: RVOT pacing increased the myocardial performance index (0.42 +/- 0.21 with RVOT pacing vs 0.35 +/- 0.21 without RVOT pacing, P = .002) and decreased the global left ventricular ejection fraction on real-time 3-dimensional echocardiography (51.4 +/- 6.2% with RVOT pacing vs 55.9 +/- 7.1% without RVOT pacing, P = .001). Intraventricular dyssynchrony of the left ventricle induced by RVOT pacing was determined by increased septal-to-posterior wall motion delay (69.7 +/- 54.0 ms with RVOT pacing vs 22.8 +/- 22.3 ms without RVOT pacing, P < .0001), increased systolic and diastolic dyssynchrony by tissue Doppler echocardiography, and increased systolic dyssynchrony index when assessed using real-time three-dimensional echocardiography (5.56 +/- 1.74% with RVOT pacing vs 4.05 +/- 1.61% without RVOT pacing, P < .0001). CONCLUSION: Acute RVOT pacing adversely affects left ventricular function and increases intraventricular dyssynchrony in patients with sick sinus syndrome.
Authors:
Wen-Hao Liu; Bih-Fang Guo; Yung-Lung Chen; Tzu-Hsien Tsai; Morgan Fu; Sarah Chua; Mien-Cheng Chen
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Publication Detail:
Type:  Journal Article     Date:  2010-04-18
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  23     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  599-607     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Affiliation:
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan, China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arrhythmias, Cardiac / etiology
Cardiac Pacing, Artificial / adverse effects*,  methods
Female
Humans
Male
Middle Aged
Sick Sinus Syndrome / therapy*
Ventricular Dysfunction, Left / etiology*
Comments/Corrections
Comment In:
J Am Soc Echocardiogr. 2010 Jun;23(6):608-10   [PMID:  20497860 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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