Prevalence and determinants of left ventricular systolic dyssynchrony in patients with normal ejection fraction received right ventricular apical pacing: a real-time three-dimensional echocardiographic study

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
Fang FangCheuk-Man Yu

Abstract

Right ventricular apical (RVA) pacing may induce mechanical dyssynchrony. However, its impact on patients with normal ejection fraction (EF) is not fully understood. This study examined the prevalence and predictors of RVA pacing-induced systolic dyssynchrony by real-time three-dimensional echocardiography (RT3DE), and evaluated its impact on left ventricular (LV) function. Ninety-three patients with sinus node dysfunction and normal EF (>50%) received RVA-based dual-chamber pacing were assessed by RT3DE during RVA pacing (V-pace) and intrinsic conduction (V-sense). Systolic dyssynchrony was evaluated using the standard deviation of the time to minimal regional volume of 16 LV segments (Tmsv-16SD), and a cutoff value of 16 ms was determined from 93 normal controls. Systolic dyssynchrony was induced in 49.5% of patients at V-pace with significant increase in LV end-systolic volume (LVESV), decrease in EF, and worsening of Tmsv-16SD (all P < 0.001). Furthermore, patients who developed dyssynchrony had larger LVESV (P < 0.001), lower EF (P < 0.001) at V-pace mode, and higher cumulative percentage of RVA pacing in the past 6 months (P < 0.001) than those without systolic dyssynchrony. In multivariate logistic regression analysis, i...Continue Reading

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Citations

Feb 3, 2012·European Heart Journal·John E Sanderson, Cheuk-Man Yu
Feb 5, 2016·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·Fang FangCheuk-Man Yu
Feb 13, 2018·Current Heart Failure Reports·Justin GouldChristopher A Rinaldi
Feb 15, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Miki TsujiuchiHiroshi Suzuki
Dec 23, 2011·Journal of Cardiovascular Translational Research·Alan J BankKevin V Burns
Jul 28, 2012·Progress in Biophysics and Molecular Biology·Andreas A WerdichDavid S Rosenbaum

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