Effects of single-site versus biventricular epicardial pacing on myocardial performance in an immature animal model of atrioventricular block.
Introduction: Single-site ventricular pacing results in dyssynchronous ventricular activation and may contribute to ventricular dysfunction. We evaluated epicardial biventricular (BiV) pacing as a means of maintaining synchronous ventricular activation in an acute piglet model of AV block with norma...
| Published in: | Journal of Cardiovascular Electrophysiology Vol. 17; no. 8; pp. 884 - 890 |
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| Main Authors: | , , , , , , , , |
| Format: | diagnostic images research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Aug2006
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106169138&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106169138 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Aug2006 vid: 17 iid: 8 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106169138 2009259371 10.1111/j.1540-8167.2006.00504.x NLM16903967 106169138 ppf: 884 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Effects of single-site versus biventricular epicardial pacing on myocardial performance in an immature animal model of atrioventricular block. aug: au: Cojoc A Reeves JG Schmarkey L Strieper MJ Joyner RW Wagner MB Campbell RM Vinten-Johansen J Frias PA affil: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA. sug: subj: Cardiac Pacing, Artificial Heart Block Animals Funding Source Swine Animal Studies ab: Introduction: Single-site ventricular pacing results in dyssynchronous ventricular activation and may contribute to ventricular dysfunction. We evaluated epicardial biventricular (BiV) pacing as a means of maintaining synchronous ventricular activation in an acute piglet model of AV block with normal ventricular anatomy and function. Methods and Results: We used left ventricular (LV) impedance catheters and tissue Doppler imaging to assess the cardiodynamics of immature piglets (n = 6, 33-78 days, 9.35 ± 0.85 kg). Following catheter ablation of the AV node, a pacemaker was programmed 20 beats per minute above the intrinsic atrial rate. The animals were paced at 5-minute intervals via the following AV sequential configurations: Right atrial appendage (RA)-RV apex (RVA), RA-LV apex (LVA), and RA-biventricular (RVA/LVA). RA-RVA was the experimental control. LV systolic mechanics, measured by the slope of the end-systolic pressure-volume relationship (Ees), increased with BiV pacing (12.8 ± 3.4 mmHg/mL, P < 0.02) or single-site LVA pacing (10.6 ± 3.4 mmHg/mL, P < 0.05) compared with single-site RVA pacing (8.3 ± 1.4 mmHg/mL). QRS duration lengthened compared with sinus rhythm (42 ± 8 msec) with either RVA (56 ± 9 msec, P < 0.02) or LVA (54 ± 7 msec, P < 0.03), but not with BiV (48 ± 7 msec, P = 0.08) pacing. Tissue Doppler imaging showed LV dyssynchrony with RVA (septal-to-lateral delay 46.0 ± 51.7 msec), with return toward normal with LVA (-9.6 ± 33.6 msec, P < 0.04) or BiV (-4.1 ± 33.8 msec, P < 0.04) pacing. Conclusions: In this acute immature piglet model of AV block, LV performance improved with single-site pacing from the LVA and BiV pacing (RVA/LVA), as compared with single-site pacing from the RVA. These changes correlated with tissue Doppler indices of mechanical synchrony, though not necessarily with QRS duration. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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