Document Detail

The immediate effects of pacemaker-related electric remodelling on left ventricular function in patients with sick sinus syndrome.
MedLine Citation:
PMID:  19880851     Owner:  NLM     Status:  MEDLINE    
AIMS: The immediate effects of electric remodelling on the left ventricular (LV) function by dual-chamber pacemakers remain unknown. The purpose of our study was to assess the interaction between heart rates and right ventricular pacing (VP) on LV contractility and diastolic function. METHOD AND RESULTS: Twenty-five patients with dual-chamber pacemakers and sick sinus syndrome were evaluated. Echocardiographic examinations included standard and tissue-Doppler echocardiography at bilateral mitral annulus margins under either the intrinsic atrio-ventricular sequential conduction (ventricular sensing; VS) mode or right ventricular apical pacing (VP) mode. Under either mode, we accelerated the pacing rate at an increment of 15 b.p.m. step-by-step from 60 to 90/min. The tissue-Doppler echocardiography of mitral annulus showed that under the VS status, accelerating atrial pacing rate from 60 to 90 b.p.m. enhanced A'-wave velocity (P < or =0.002), whereas no significant change of LV ejection fraction (LVEF) and E'-wave velocity were noted. Under the VP status, acceleration of pacing rates exerted no effect on the LVEF, E'-, and A'-wave (P = NS). While shifting the pacemaker mode from VS to VP, the E'-wave velocity (P < or =0.002) and E'/A' ratio decreased significantly (P < or = 0.001). The A'-wave velocity also increased significantly during shifting to VP mode at 60 b.p.m. (P < or =0.004). CONCLUSION: At fixed pacing rates, shifting from VS to VP mode impaired LV diastolic function immediately with preserved LV contractility. The acceleration of heart rate impaired LV diastolic function under VS mode.
Yu-Chen Wang; Yen-Hung Lin; Yen-Bin Liu; Jen-Kuang Lee; Ying-Shren Chen; Hsiu-Hao Lee; Lung-Chun Lin; Yi-Lwun Ho; Wen-Jone Chen
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-10-31
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:  11     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  1660-5     Citation Subset:  IM    
Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
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MeSH Terms
Aged, 80 and over
Cardiac Pacing, Artificial / adverse effects*
Middle Aged
Sick Sinus Syndrome / complications*,  diagnosis,  prevention & control*
Treatment Outcome
Ventricular Dysfunction, Left / diagnosis*,  etiology*

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