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- Title
Hemodynamic Benefits of Right Ventricular Outflow Tract Pacing: Comparison with Right Ventricular Apex Pacing.
- Authors
de Cock, Carel C.; Meyer, Albert; Kamp, Otto; Visser, Cees A.
- Abstract
To assess optimal hemodynamics in relation to stimulation site during right ventricular pacing, 17 consecutive patients who underwent cardiac catheterization were studied. In all patients, right ventricular apex and right ventricular outflow tract stimulation was performed at 85, 100, and 120 beats/mm. Cardiac index at both pacing sites was compared using the left ventricular out-flow tract continuous wave Doppler technique. Comparison of the two stimulation sites demonstrated that right ventricular outflow tract pacing resulted in a higher cardiac index at 85 beats/mm (2.42 ± 1.2 vs 2.04 ± 1.0 L/min per m2, P < 0.002) at 100 beats/min (2.78 ± 1.4 vs 2.35 ± 1.1 L/min per m2, P < 0.001) and 120 beats/mm (3.00 ± 1.5 vs 2.61 ± 0.9 L/min per m2, P < 0.001). From a total of 51 paired observations, 45 showed an increase in cardiac index during outflow tract pacing as compared to apex pacing. Right ventricular outflow tact pacing at 120 beats/mm resulted in a lower cardiac index than right ventricular apex pacing in patients with significant coronary artery disease arid/or impaired left ventricular function (ejection fraction s 50%), whereas right ventricular outflow tract pacing produced higher cardiac indices in the absence of these abnormalities. Right ventricular outflow tract pacing resulted in higher cardiac in- dices as compared to apex pacing in all other subgroups at all other pacing sites tested. It is concluded that stimulation of the right ventricular outflow tract offers a significant hemodynamic benefit during single chamber pacing as compared to conventional apex pacing. particularly in the absence of significant coronary artery disease and/or left ventricular dysfunction.
- Subjects
CARDIAC pacing; HEMODYNAMICS; CORONARY disease; CATHETERIZATION; CARDIAC surgery; ARRHYTHMIA treatment
- Publication
Pacing & Clinical Electrophysiology, 1998, Vol 21, Issue 3, p536
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1998.tb00095.x