Evaluation of Different Ventricular Pacing Sites in Patients With Severe Heart Failure

DOI Web Site 被引用文献5件
  • Jean-Jacques Blanc
    From the Department of Cardiology, Brest (France) University Hospital (J.-J.B., Y.E., M.G., J.M., S.M., J.B.) and the Cardiac Arrhythmia Center, University of Minnesota, Minneapolis (D.G.B., K.G.L.).
  • Yves Etienne
    From the Department of Cardiology, Brest (France) University Hospital (J.-J.B., Y.E., M.G., J.M., S.M., J.B.) and the Cardiac Arrhythmia Center, University of Minnesota, Minneapolis (D.G.B., K.G.L.).
  • Martine Gilard
    From the Department of Cardiology, Brest (France) University Hospital (J.-J.B., Y.E., M.G., J.M., S.M., J.B.) and the Cardiac Arrhythmia Center, University of Minnesota, Minneapolis (D.G.B., K.G.L.).
  • Jacques Mansourati
    From the Department of Cardiology, Brest (France) University Hospital (J.-J.B., Y.E., M.G., J.M., S.M., J.B.) and the Cardiac Arrhythmia Center, University of Minnesota, Minneapolis (D.G.B., K.G.L.).
  • Stéphane Munier
    From the Department of Cardiology, Brest (France) University Hospital (J.-J.B., Y.E., M.G., J.M., S.M., J.B.) and the Cardiac Arrhythmia Center, University of Minnesota, Minneapolis (D.G.B., K.G.L.).
  • Jacques Boschat
    From the Department of Cardiology, Brest (France) University Hospital (J.-J.B., Y.E., M.G., J.M., S.M., J.B.) and the Cardiac Arrhythmia Center, University of Minnesota, Minneapolis (D.G.B., K.G.L.).
  • David G. Benditt
    From the Department of Cardiology, Brest (France) University Hospital (J.-J.B., Y.E., M.G., J.M., S.M., J.B.) and the Cardiac Arrhythmia Center, University of Minnesota, Minneapolis (D.G.B., K.G.L.).
  • Keith G. Lurie
    From the Department of Cardiology, Brest (France) University Hospital (J.-J.B., Y.E., M.G., J.M., S.M., J.B.) and the Cardiac Arrhythmia Center, University of Minnesota, Minneapolis (D.G.B., K.G.L.).

書誌事項

タイトル別名
  • Results of an Acute Hemodynamic Study
公開日
1997-11-18
DOI
  • 10.1161/01.cir.96.10.3273
公開者
Ovid Technologies (Wolters Kluwer Health)

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説明

<jats:p> <jats:italic>Background</jats:italic> Multisite ventricular pacing has recently been proposed as an additional treatment for patients with severe congestive heart failure. To further assess the potential value of this technique, we compared the acute hemodynamic changes associated with pacing the right ventricular apex (RVA) or outflow tract (RVOT) alone, the left ventricle (LV) alone, or biventricular (BIV) pacing of the RVA and LV together. </jats:p> <jats:p> <jats:italic>Methods and Results</jats:italic> Acute hemodynamic findings were measured in 27 patients with severe heart failure despite optimal therapy and either first-degree AV block and/or an intraventricular conduction defect. In the 23 patients with a high pulmonary capillary wedge pressure (PCWP) (>15 mm Hg), data were collected after transvenous pacing at different ventricular sites in either the VDD mode (AV delay=100 ms) or the VVI mode in patients with atrial fibrillation (n=6). The mean baseline cardiac index was 1.82 L · min <jats:sup>−1</jats:sup> · m <jats:sup>−2</jats:sup> . Mean±SD baseline systolic blood pressure (SBP) (118.5±15.2 mm Hg), PCWP (26.4±6.6 mm Hg), and V-wave amplitude (39.1±14.6 mm Hg) were similar before and after either RVA or RVOT pacing. In contrast, LV-based pacing (either LV alone or BIV pacing) resulted in higher SBP ( <jats:italic>P</jats:italic> <.03) and lower PCWP ( <jats:italic>P</jats:italic> <.01) and V-wave amplitude ( <jats:italic>P</jats:italic> <.001) than either baseline or RV pacing measurements. With LV pacing alone, SBP, PCWP, and V waves were 126.5±15.1, 20.7±5.9, and 25.5±8.1 mm Hg, respectively. The results with LV pacing alone were similar to those obtained with BIV pacing. </jats:p> <jats:p> <jats:italic>Conclusions</jats:italic> In patients with severe congestive heart failure, both LV pacing alone and BIV pacing resulted in a similar and significant acute improvement in SBP, PCWP, and V-wave amplitude compared with baseline measurements and RV pacing alone. These results provide a strong basis for initiating long-term studies examining the chronic effects of LV-based pacing in patients with medically refractory congestive heart failure. </jats:p>

収録刊行物

  • Circulation

    Circulation 96 (10), 3273-3277, 1997-11-18

    Ovid Technologies (Wolters Kluwer Health)

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