Abstract
Patients with atrioventricular (AV) block can develop left ventricular (LV) dysfunction with long-term right ventricular pacing (RVP). We investigated the role of RVP-induced LV dyssynchrony in this adverse remodeling. Nineteen patients with normal LV function undergoing pacemaker implantation for AV block were included. Right ventricular pacing leads were positioned at the apex. Two-dimensional and tissue Doppler echocardiography was performed before and immediately after implantation and at the end of follow-up. The maximal delay between peak velocities of opposing basal LV walls was measured using tissue Doppler echocardiography, as an index of LV dyssynchrony. With the initiation of RVP, LV dyssynchrony increased in some patients and decreased in others, as compared with intrinsic rhythm. The RVP-induced change in dyssynchrony inversely correlated with baseline dyssynchrony (r = -0.686, P = .010). After 28 ± 3.6 months, LV end-systolic volume (ESV) increased, and ejection fraction decreased (from 34 ± 12 to 40 ± 20 mL, P = .010 and from 65% ± 6% to 56% ± 11%, P < .001, respectively). The change in LV ESV was greater in patients with 60% or greater cumulative RVP (9.9 vs 0.08 mL, P = .027). Within this frequently paced group...Continue Reading
References
Jun 5, 2003·Circulation·Michael O SweeneyUNKNOWN MOde Selection Trial Investigators
May 20, 2004·Journal of Cardiovascular Electrophysiology·Gabe B BleekerJeroen J Bax
Oct 19, 2006·Journal of the American College of Cardiology·Laurens F TopsJeroen J Bax
Jan 17, 2007·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·Martin SchmidtMichael Block
Oct 2, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Wen-Hao LiuHsueh-Wen Chang
Nov 17, 2007·Journal of Cardiovascular Electrophysiology·Xue-Hua ZhangHung-Fat Tse
Feb 13, 2008·Journal of Cardiovascular Electrophysiology·Brandon K FornwaltPatricio A Frias
Mar 4, 2008·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·John GorcsanUNKNOWN Heart Rhythm Society
Oct 28, 2008·Pacing and Clinical Electrophysiology : PACE·Gianni PastoreS Serge Barold
Dec 17, 2008·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·David D McManusNelson B Schiller
Aug 20, 2009·Circulation Journal : Official Journal of the Japanese Circulation Society·Yoshio TakemotoItsuo Kodama
Aug 25, 2009·The American Journal of Cardiology·Wen-Jing HongYiu-fai Cheung
Nov 17, 2009·The New England Journal of Medicine·Cheuk-Man YuJeffrey Wing-Hong Fung