Skip Navigation



Europace Advance Access published online on November 6, 2009
Europace, doi:10.1093/europace/eup342
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 Gebauer, R. A.
Right arrow Articles by Janousek, J.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gebauer, R. A.
Right arrow Articles by Janousek, J.
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 2009. For permissions please email: journals.permissions@oxfordjournals.org.

CLINICAL RESEARCH

Differential effects of the site of permanent epicardial pacing on left ventricular synchrony and function in the young: implications for lead placement

Roman A. Gebauer1,*, Viktor Tomek2, Petr Kubus2, Vít Rázek1, Tomás Matejka2, Aida Salameh1, Martin Kostelka3 and Jan Janousek1

1 Department of Pediatric Cardiology, Heart Center, University of Leipzig, Strümpellstrasse 39, 04289 Leipzig, Germany; 2 Kardiocentrum and Cardiovascular Research Center, University Hospital Motol, Prague, Czech Republic; 3 Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany

Aims: To analyse left ventricular (LV) synchrony and function with respect to the epicardial pacing site in the young.

Methods and results: Left ventricular function and synchrony (M-mode, speckle tracking) were evaluated during mid-term follow-up in 32 children with complete non-surgical (n = 15) or surgical (n = 17) atrioventricular block (structural heart disease in 21/32) paced from LV apex (n = 19), right ventricular (RV) apex (n = 7), and RV free wall (n = 6), respectively. Data are in the following order: LV apical, RV apical, and RV free wall pacing. Septal to posterior wall motion delay (SPWMD) = median 0, 69, and 136 ms (P < 0.001), septal to lateral mechanical delay = 54 ± 29, 73 ± 24, and 129 ± 70 ms (P = 0.001), apical to basal mechanical delay = 96 ± 37, 106 ± 50, and 79 ± 18 ms (P NS), and LV ejection fraction (LVEF) = 57 ± 9, 49 ± 12, and 33 ± 10% (P < 0.001), respectively. Left ventricular ejection fraction correlated negatively with SPWMD (R2 = 0.454, P < 0.001) and septal to lateral mechanical delay (R2 = 0.320, P < 0.001) but not with apical to basal mechanical delay. Right ventricular free wall pacing (P = 0.014) and SPWMD (P = 0.044) were negative multivariable predictors of LVEF.

Conclusion: Compared with other sites, LV apical pacing preserves septal to lateral LV synchrony and systolic function and may be the preferred epicardial pacing site in the young.

Key Words: Permanent pacing, Heart block, Ventricular dysfunction, Left ventricular pacing, Right ventricular pacing, Children

* Corresponding author. Tel: +49 341 865 1036, Fax: +49 341 865 1143, Email: roman.gebauer{at}med.uni-leipzig.de

Manuscript submitted 26 August 2009. Accepted after revision 6 October 2009.


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.