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- Title
Acute Effects of Biventricular Pacing in Heart Failure Patients with a Normal Ejection Fraction and Mechanical Dyssynchrony.
- Authors
Wang, Yi-Chih; Yu, Chih-Chieh; Chiu, Fu-Chun; Splett, Vincent; Klepfer, Ruth; Hilpisch, Kathryn; Tsai, Chia-Ti; Lai, Ling-Ping; Hwang, Juey-Jen; Lin, Jiunn-Lee
- Abstract
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. © 2015 S. Karger AG, Basel
- Subjects
HEART failure treatment; PATIENT-ventilator dyssynchrony; HEMODYNAMICS; LEFT heart ventricle diseases; SYSTOLIC blood pressure
- Publication
Cardiology, 2015, Vol 130, Issue 2, p112
- ISSN
0008-6312
- Publication type
Article
- DOI
10.1159/000368795