Skip Navigation

Europace 2008 10(12):1387-1391; doi:10.1093/europace/eun306
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Bildirici, U.
Right arrow Articles by Ural, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bildirici, U.
Right arrow Articles by Ural, D.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Cardiac resynchronization therapy

Comparison of the effects of left vs. right ventricular pacing on left ventricular remodelling

Ulas Bildirici*, Ahmet Vural, Aysen Agacdiken, Tayfun Sahin, Umut Celikyurt, Teoman Kiliç and Dilek Ural

Department of Cardiology, Kocaeli University Medical Faculty, 41380 Kocaeli, Turkey

Aims: Patients having conduction disease and indications for a standard pacemaker implantation are treated with right ventricular (RV)-based pacemaker therapy. The aim of this study was to investigate echocardiographic and clinical effects of RV and left ventricular (LV)-based pacing in patients with standard pacemaker indication and LV dysfunction.

Methods and results: Thirty-nine patients with symptomatic bradycardia due to sinus or atrioventricular nodal dysfunction and having absolute standard pacemaker indication, low LV ejection fraction (EF) (35–50%) and QRS duration <120 ms were included in the study. Pacemaker properties, echocardiographic, and clinical results were evaluated in both patient groups after a long-term follow-up period. A significant increase in LVEF (left ventricular ejection fraction) was observed in left pacing group (from 37 ± 10 to 41 ± 9%, P < 0.01) and a statistically significant decrease in right pacing group (from 40 ± 7 to 37 ± 10%, P < 0.05). Intraventricular asynchrony was not developed in left pacing group, whereas significant asynchrony occurred in 73% of patients in right pacing group. New-onset interventricular asynchrony was detected in three and 10 patients in LV pacing group and RV pacing groups, respectively. Intraventricular and interventricular asynchrony was found together in seven of RV lead implanted patients. Although statistically insignificant, LV end-diastolic diameter was increased (from 56 ± 6 to 60 ± 6 mm) and EF was decreased (from 39 ± 7 to 33 ± 9%) in these patients (P = 0.07). During follow-up, 40% of patients in RV pacing group were admitted to the hospital due to heart failure in contrast to LV pacing group.

Conclusion: LV-based pacemaker implantation is more suitable for patients having standard pacemaker indications and LV dysfunction even in the absence of ventricular asynchrony.

Key Words: Left ventricular pacing, Right ventricular pacing, Left ventricular remodelling, Asynchrony, Heart failure

* Corresponding author. Tel: +90 262 303 8484, Email: ihubildir{at}gmail.com

Manuscript submitted 4 June 2008. Accepted after revision 17 October 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.