Acute Effects of Biventricular Pacing in Heart Failure Patients with a Normal Ejection Fraction and Mechanical Dyssynchrony
| Autor: | Ruth N. Klepfer, Kathryn Hilpisch, Fu Chun Chiu, Chia Ti Tsai, Vincent E. Splett, Jiunn Lee Lin, Chih Chieh Yu, Yi-Chih Wang, Ling Ping Lai, Juey-Jen Hwang |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Acute effects medicine.medical_specialty Systole Heart Ventricles Hemodynamics Cardiac Resynchronization Therapy Diastole Internal medicine Humans Medicine Pharmacology (medical) Cardiac Resynchronization Therapy Devices Heart Atria Aged Ultrasonography Heart Failure Ejection fraction business.industry Stroke Volume medicine.disease Heart failure Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiology. 130:112-119 |
| ISSN: | 1421-9751 0008-6312 |
| DOI: | 10.1159/000368795 |
| Popis: | Objectives: We tested the acute effects of resynchronization in heart failure patients with a normal (>50%) left ventricular (LV) ejection fraction (HFNEF) and mechanical dyssynchrony. Methods: Twenty-four HFNEF patients (72 ± 6 years, 5 male) with mechanical dyssynchrony (standard deviation of electromechanical time delay among 12 LV segments >35 ms) were studied with temporary pacing catheters in the right atrium, LV, and right ventricle (RV), and high-fidelity catheters for pressure recording. Using selected atrioventricular (AV) intervals of 60, 90, 120, 150, and 180 ms to optimize transmitral flow during simultaneous biventricular pacing, the RV-LV (VV) interval was then evaluated at RV30, RV15, 0, LV15, LV30, and LV45 (RV or LV indicates which ventricle was paced first, the number indicates by how many ms). Results: During simultaneous pacing, longer AV intervals were associated with improved LV pressure-derivative minimums and increased aortic pressures (p < 0.05 vs. normal sinus rhythm). In the VV interval from RV30 to LV45, there was a graded increase in the aortic velocity time integral and a decrease in dyssynchrony during simultaneous or LV-first pacing (p < 0.05 vs. normal sinus rhythm). Conclusions: For HFNEF patients with mechanical dyssynchrony, acute simultaneous biventricular or LV-first pacing with longer AV intervals reduced mechanical dyssynchrony and improved diastolic and systolic hemodynamics. |
| Databáze: | OpenAIRE |
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