Rodríguez-Serrano G, Lara-Vaca S, Pereyra-Nobara T, Bernal-Ruiz E

Language: Spanish
References: 11
Page: 309-313
PDF size: 290.48 Kb.

ABSTRACT

Background: Placing the right ventricular pacing electrode in different places than the apex is less deleterious to the ejection fraction and left ventricular synchrony. Currently it is not defined which non apical site is better alternative. The aim of this paper was to determine if there is a difference in systolic function and left ventricular synchrony with stimulation of medial septum or outflow tract of the right ventricle in patients with atrioventricular block and pacemaker device.
Methods: This was an observational analytical cross study. The patients included in this study were the population over 18 years old, diagnosed with atrioventricular block and pacemaker device. Two groups were divided according to the site of electrode placement whether in medial septum region or outflow tract of the right ventricle. The ejection fraction and left ventricular synchrony was determined by echocardiogram.
Results: 54 patients were included in each group, with similar demographic characteristics, except for the time of placement of ventricular electrode (p = ‹ 0.001). No significant difference in ejection fraction or left ventricular synchrony was found.
Conclusions: There were no differences in ejection fraction or left ventricular synchrony regardless of the ventricular electrode placement.

REFERENCES

1. Furman S, Schwedel J. An intracardiac pacemaker for Stokes-Adams seizures. N Eng J Med. 1959; 261:943-8.

2. Wyman BT, Hunter WC, Prinzen FW, McVeigh ER. Mapping propagation of mechanical activation in the paced heart with MRI tagging. Am J Physiol. 1999; 276(3):H881-H91.

3. Prinzen FW, Augustijn CH, Arts T, Allessie MA, Reneman RS. Redistribution of myocardial fiber strain and blood flow by asynchronous activation. Am J Physiol. 1990;259(2):H300-H8.

4. Prinzen FW, Hunter WC, Wyman BT, McVeigh ER. Mapping of regional myocardial strain and work during ventricular pacing: experimental study using magnetic resonance imaging tagging. J Am Coll Cardiol. 1999;33(6):1735-42.

5. Sweeney MO, Hellkamp AS, Ellenbogen KA, Greenspon AJ, Freedman RA, Lee KL et al. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation. 2003;107(23):2932-7.

6. Tops LF, Schalij MJ, Bax JJ. The effects of right ventricular apical pacing on ventricular function and dyssynchrony. J Am Coll Cardiol. 2009;54(9):764-76.

7. Zanon F, Barraca E, Aggio S, Pastore G, Cardano P, Marotta T et al. A feasible approach for direct His-bindle pacing using a new steerable catheter to facilitate precise lead placement. J Cardiovasc Electrophysiol. 2006;17(1):29-33.

8. Occhetta E, Bornik M, Magnani A, Francalacci G, Piccinino C, Plebani L, Marino P. Prevention of ventricular desynchronization by permanent para-hisian pacing after atriventricular node ablation in chronic atrial fibrillation. J Am Coll Cardiol. 2006;47(10) 1938-1945.

9. Leong D, Mitchell A, Salna I, Brooks A, Sharma G, Lim HS et al. Long-term mechanical consequences of permanent right ventricular pacing: effect of pacing site. J Cardiovasc Electrophysiol. 2010;21(10): 1120-1126.

10. Rosso R, Medi C, Teh AW, Hung TT, Feldman A, Lee G et al. Right ventricular septal pacing: a comparative study of outflow tract and mid ventricular sites. PACE. 2010;33(10):1169-73.

11. Makoto S, Negishi K, Kaye G, Linker N, Gamage M, Marwick T. Effect of right ventricular pacing site on global left ventricular myocardial deformation: Role of dyssynchrony and regional function. J Am Coll Cardiol. 2014;63(12 S).