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Europace Advance Access originally published online on April 10, 2008
Europace 2008 10(5):574-579; doi:10.1093/europace/eun085
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

ALTERNATIVE VENTRICULAR PACING SITES

Long-term outcomes in patients with atrioventricular block undergoing septal ventricular lead implantation compared with standard apical pacing

Alexander Kypta, Clemens Steinwender, Jürgen Kammler, Franz Leisch and Robert Hofmann*

First Department of Internal Medicine, Cardiovascular Division, Academic Teaching and General Hospital Linz, Krankenhausstrasse 9, A-4020 Linz, Austria

See page 572 for the editorial comment on this article (doi: 10.1093/europace/eun087)

Aims: Left ventricular function may be altered by right ventricular apical pacing. The aims of the study were to compare the long-term course of different parameters of left ventricular dysfunction in patients undergoing implantation of a dual-chamber pacemaker with the ventricular lead in a septal position vs. in a standard apical position.

Methods: We randomized 98 patients with atrioventricular block (AV-block) undergoing pacemaker implantation to positioning the ventricular lead in the high or mid septum (n = 53) or in the apex (n = 45) of the right ventricle. N-terminal pro-brain natriuetic peptide (BNP) levels, left ventricular ejection fraction (LVEF), and exercise capacity were analysed 3 days, 3 months, and 18 months after the implantation. The primary endpoints were the changes of these parameters from baseline to 18 months.

Results: Changes of BNP levels, LVEF, and exercise capacity from baseline to 18 months were statistically not different between septal and apical stimulation. The clinical occurrence or deterioration of overt heart failure was similar in both treatment arms.

Conclusion: With regard to different parameters of congestive heart failure, a septal stimulation site is not superior to conventional apical pacing in unselected patients undergoing pacemaker implantation for AV-block.

Key Words: Apical pacing, Septal pacing, Ventricular function, Congestive heart failure

* Corresponding author. Tel: +43 732 7806 6210; fax: +43 732 7806 6205.E-mail address: robert.hofmann{at}akh.linz.at

Manuscript submitted 20 July 2007. Accepted after revision 11 February 2008.


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Europace 2008 10: 572-573. [FREE Full Text]  





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