Coupled pacing improves left ventricular function during simulated atrial fibrillation without mechanical dyssynchrony
| Autor: | Patrick J. Tchou, George E. Yanulis, David Verhaert, Don W. Wallick, Richard A. Grimm, Pascal Lim, Nicolas Lellouche, Neil L. Greenberg |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Cardiac output genetic structures Systole medicine.medical_treatment Diastole Cardiac resynchronization therapy Ventricular Function Left Electrocardiography Ventricular Dysfunction Left Dogs Heart Rate Physiology (medical) Internal medicine Atrial Fibrillation medicine Animals cardiovascular diseases Ejection fraction business.industry Cardiac Pacing Artificial Atrial fibrillation medicine.disease Disease Models Animal Blood pressure Anesthesia cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business Vagus nerve stimulation circulatory and respiratory physiology |
| Zdroj: | EP Europace. 12:430-436 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Aims Electrical stimulation [coupled pacing (CP)] applied near the end of the T-wave is able to create a retrograde activation of the atrioventricular (AV) node in turn to prevent rapid ventricular conduction during atrial fibrillation (AF). The impact of this pacing modality associated with cardiac resynchronization therapy (CRT) has been evaluated in the present experimental study. Methods and results After inducing AF by rapid pacing in six dogs, we applied the following pacing modalities: rapid right ventricular (RV) pacing, rapid CRT, CRT with an additional RV paced beat (CP) at a specific delay (CRT + CP), and CRT with vagal stimulation (CRT-VS). Left ventricular (LV) pressure recordings and echocardiography for 2D strain analysis were performed. CRT + CP reduced the ventricular response rate and increased the LV systolic pressure and cardiac output compared with CRT alone (136 ± 6 vs. 86 ± 13 mmHg, P < 0.05 and 2.0 ± 0.4 vs.1.2 ± 0.1, P < 0.05 L/m, respectively). Compared with CRT-VS, CRT + CP increased the LV ejection fraction (LVEF = 51 ± 10 vs. 28 ± 4%, P < 0.05), peak global circumferential strain (−17 ± 2 vs. −11 ± 3%), and diastolic filling time (49 ± 6 vs. 28 ± 3%, P < 0.02) suggesting beneficial effects of CP beyond rate control. CRT + CP did not result in increased dyssynchrony [CRT (8.3 ± 2%) vs. CRTCP (8.4 ± 3%, P = NS)]. Conclusion CRT + CP effectively reduces ventricular contractile rate and leads to an increase in systolic and diastolic performance without inducing mechanical dyssynchrony. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|