Altered left ventricular contraction pattern during right ventricular pacing: assessment using real-time three-dimensional echocardiography.
Chronic right ventricular apical (RVA) pacing has been associated with increased risk of heart failure and adverse outcome. The acute effects of RVA pacing on three-dimensional (3D) ventricular function and mechanical dyssynchrony are not well known. We performed a real-time 3D echocardiographic (RT...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 34; no. 1; pp. 76 - 82 |
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| Autores principales: | , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jan2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104979740&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104979740 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jan2011 vid: 34 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104979740 57220164 10.1111/j.1540-8159.2010.02908.x NLM20946287 104979740 ppf: 76 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Altered left ventricular contraction pattern during right ventricular pacing: assessment using real-time three-dimensional echocardiography. aug: au: WOLBER T HAEGELI L HUERLIMANN D BRUNCKHORST C LÜSCHER TF DURU F affil: Center for Integrative Human Physiology, University of Zurich, Zurich, SwitzerlandClinic for Cardiology, Cardiovascular Center, University Hospital Zurich, Zurich, Switzerland sug: subj: Echocardiography, Three-Dimensional Heart Ventricle, Left Physiopathology Heart Conduction System Physiopathology Heart Ventricle, Right Physiopathology Ventricular Dysfunction, Left Physiopathology Defibrillators, Implantable Descriptive Statistics Pacemaker, Artificial Quantitative Studies Systolic Pressure Physiology T-Tests One-Way Analysis of Variance Human Male Female Middle Age Aged Adult Funding Source Middle Aged: 45-64 years Aged: 65+ years Adult: 19-44 years Male Female ab: Chronic right ventricular apical (RVA) pacing has been associated with increased risk of heart failure and adverse outcome. The acute effects of RVA pacing on three-dimensional (3D) ventricular function and mechanical dyssynchrony are not well known. We performed a real-time 3D echocardiographic (RT3DE) study to assess global and regional left ventricular function during RVA pacing. Twenty-six patients with implanted cardiac devices and normal intrinsic atrioventricular conduction were included in the study. RT3DE was performed during intrinsic sinus rhythm and during RVA pacing. Quantification of global and regional left ventricular function was performed offline by time-volume analysis of 16 myocardial segments. Time to reach minimum regional volume was calculated for each segment as a percentage of the cardiac cycle. The systolic dyssynchrony index (SDI) was defined as the standard deviation of these time periods. Longitudinal function was assessed by time-volume analysis of apical, midventricular, and basal segments. During RVA pacing, a reversed apical-to-basal longitudinal contraction sequence was observed in 58% of all patients. RVA pacing was associated with increased left ventricular (LV) dyssynchrony (SDI increase from 4.4 ± 2.2% to 6.3 ± 2.4%, P = 0.001) and reduced LV ejection fraction (decrease from 53 ± 13% to 47 ± 14%, P = 0.05). RT3DE assessment of LV function provides evidence that pacing from the RVA results in acute alterations in LV contraction sequence and increased LV dyssynchrony. Further studies are warranted to assess the potential of RT3DE to identify patients who might be at increased risk of pacing-induced heart failure or who might benefit from alternate-site or multisite pacing. (PACE 2011; 76-81) pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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