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Article: Impacts of ventricular rate regularization pacing at right ventricular apical vs. septal sites on left ventricular function and exercise capacity in patients with permanent atrial fibrillation

TitleImpacts of ventricular rate regularization pacing at right ventricular apical vs. septal sites on left ventricular function and exercise capacity in patients with permanent atrial fibrillation
Authors
Issue Date2009
PublisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/
Citation
Europace, 2009, v. 11 n. 5, p. 594-600 How to Cite?
AbstractAimsThe deleterious effects of right ventricular apex (RVA) pacing may offset the potential benefit of ventricular rate (VR) regularization during atrial fibrillation (AF). Recent studies suggested that right ventricular septal (RVS) pacing may prevent the potential deleterious effects of RVA pacing and enhance the VR regularization (VRR) with ventricular pacing due to closer proximity of the pacing site to the retrograde atrioventricular conduction.Methods and resultsWe randomized 24 patients with permanent AF and symptomatic bradycardia to undergo RVA (n = 12) or RVS (n = 12) pacing. A VRR algorithm was programmed for all patients at 6-month after implantation. All patients underwent 6 min hall walk (6MHW) to assess exercise capacity at 6, 12, and 24 months, and radionuclide ventriculography to determine left ventricular ejection fraction (LVEF) at 6 and 24 months. Baseline characteristics were comparable in both groups except pacing QRS duration was significantly shorter during RVS pacing than RVA pacing (132 ± 4 vs. 151 ± 6 ms, P = 0.012). In both groups, VRR significantly increased the percentage of ventricular pacing and reduced VR variability (P < 0.05) without increasing mean VR (P > 0.05). At 6 months, 6MHW and LVEF were comparable in patients with RVA and RVS pacing (P > 0.05). At 24 months, patients with RVA pacing had significant decreases in LVEF and 6MHW after VRR pacing (P < 0.05), whereas RVS pacing with VRR preserved LVEF and improved 6MHW (P < 0.05).ConclusionIn patients with permanent AF, VRR pacing at RVS, but not at RVA, preserves LVEF and provides incremental benefit for exercise capacity.
Persistent Identifierhttp://hdl.handle.net/10722/163252
ISSN
2015 Impact Factor: 4.021
2015 SCImago Journal Rankings: 2.201
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_US
dc.contributor.authorWong, KKen_US
dc.contributor.authorSiu, CWen_US
dc.contributor.authorTang, MOen_US
dc.contributor.authorTsang, Ven_US
dc.contributor.authorHo, WYen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2012-09-05T05:29:10Z-
dc.date.available2012-09-05T05:29:10Z-
dc.date.issued2009en_US
dc.identifier.citationEuropace, 2009, v. 11 n. 5, p. 594-600en_US
dc.identifier.issn1099-5129en_US
dc.identifier.urihttp://hdl.handle.net/10722/163252-
dc.description.abstractAimsThe deleterious effects of right ventricular apex (RVA) pacing may offset the potential benefit of ventricular rate (VR) regularization during atrial fibrillation (AF). Recent studies suggested that right ventricular septal (RVS) pacing may prevent the potential deleterious effects of RVA pacing and enhance the VR regularization (VRR) with ventricular pacing due to closer proximity of the pacing site to the retrograde atrioventricular conduction.Methods and resultsWe randomized 24 patients with permanent AF and symptomatic bradycardia to undergo RVA (n = 12) or RVS (n = 12) pacing. A VRR algorithm was programmed for all patients at 6-month after implantation. All patients underwent 6 min hall walk (6MHW) to assess exercise capacity at 6, 12, and 24 months, and radionuclide ventriculography to determine left ventricular ejection fraction (LVEF) at 6 and 24 months. Baseline characteristics were comparable in both groups except pacing QRS duration was significantly shorter during RVS pacing than RVA pacing (132 ± 4 vs. 151 ± 6 ms, P = 0.012). In both groups, VRR significantly increased the percentage of ventricular pacing and reduced VR variability (P < 0.05) without increasing mean VR (P > 0.05). At 6 months, 6MHW and LVEF were comparable in patients with RVA and RVS pacing (P > 0.05). At 24 months, patients with RVA pacing had significant decreases in LVEF and 6MHW after VRR pacing (P < 0.05), whereas RVS pacing with VRR preserved LVEF and improved 6MHW (P < 0.05).ConclusionIn patients with permanent AF, VRR pacing at RVS, but not at RVA, preserves LVEF and provides incremental benefit for exercise capacity.en_US
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/en_US
dc.relation.ispartofEuropaceen_US
dc.rightsEuropace. Copyright © Oxford University Press.-
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAlgorithmsen_US
dc.subject.meshAtrial Fibrillation - Physiopathology - Therapyen_US
dc.subject.meshExercise Tolerance - Physiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Ventricles - Physiopathology - Radionuclide Imagingen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPacemaker, Artificialen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshStroke Volume - Physiologyen_US
dc.subject.meshVentricular Dysfunction, Left - Physiopathologyen_US
dc.subject.meshVentricular Dysfunction, Right - Physiopathologyen_US
dc.subject.meshVentricular Function, Left - Physiologyen_US
dc.subject.meshVentricular Septum - Physiopathology - Radionuclide Imagingen_US
dc.titleImpacts of ventricular rate regularization pacing at right ventricular apical vs. septal sites on left ventricular function and exercise capacity in patients with permanent atrial fibrillationen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.identifier.authoritySiu, CW=rp00534en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1093/europace/eup087en_US
dc.identifier.pmid19363054-
dc.identifier.scopuseid_2-s2.0-66749148979en_US
dc.identifier.hkuros158523-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-66749148979&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume11en_US
dc.identifier.issue5en_US
dc.identifier.spage594en_US
dc.identifier.epage600en_US
dc.identifier.isiWOS:000265740300015-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridWong, KK=7404758873en_US
dc.identifier.scopusauthoridSiu, CW=7006550690en_US
dc.identifier.scopusauthoridTang, MO=7401973887en_US
dc.identifier.scopusauthoridTsang, V=7005694255en_US
dc.identifier.scopusauthoridHo, WY=25938053100en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US
dc.identifier.citeulike5290741-

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