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Article: Impact of temporary interruption of right ventricular pacing for heart block on left ventricular function and dyssynchrony
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TitleImpact of temporary interruption of right ventricular pacing for heart block on left ventricular function and dyssynchrony
 
AuthorsHong, WJ1
Yung, TC1
Lun, KS1
Wong, SJ1
Cheung, YF1
 
Issue Date2010
 
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
 
CitationPace - Pacing And Clinical Electrophysiology, 2010, v. 33 n. 1, p. 41-48 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1540-8159.2009.02574.x
 
AbstractBackground: The increasing data suggest an association between chronic right ventricular (RV) and left ventricular (LV) dysfunction. We sought to determine the effect of temporary interruption of long-term RV pacing on LV function and mechanical dyssynchrony in children and young adults with complete heart block. Methods: Twelve patients aged 20.0 ± 7.4 years with congenital heart block (group I) and six patients aged 22.7 ± 11.0 years with surgically acquired heart block (group II) with RV pacing were studied. The pacing rate was reduced to less than patient's intrinsic heart rate and maintained for 5 minutes. The LV ejection fraction (EF), three-dimensional systolic dyssynchrony index (SDI), two-dimensional global longitudinal strain and strain rate, and Doppler-derived isovolumic acceleration before and after interruption of RV pacing were compared. Results: The LVEF and GLS increased while QRS duration decreased after the pacing interruption in both the groups (all P < 0.05). While SDI decreased in both groups I (6.8 ± 2.3% - 3.8 ± 0.8%, P = 0.001) and II (9.2 ± 4.1%- 5.0 ± 1.6%, P = 0.032), it remained higher in group II than in group I (P = 0.046) after the pacing interruption. The prevalence of LV dyssynchrony (SDI > 4.7%) decreased in group I (83%- 25%, P = 0.006) but not in group II (67%- 50%, P = 0.50). The %increase in LVEF correlated positively with %reduction of LV SDI (r = 0.80, P = 0.001). Conclusions: Temporary interruption of chronic RV pacing acutely improves LV dyssynchrony and systolic function in children and young adults, the magnitude of which is greater in patients with congenital than those with surgically acquired heart block. (PACE 2010; 41-48) © 2009 Wiley Periodicals, Inc.
 
ISSN0147-8389
2013 Impact Factor: 1.250
 
DOIhttp://dx.doi.org/10.1111/j.1540-8159.2009.02574.x
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorHong, WJ
 
dc.contributor.authorYung, TC
 
dc.contributor.authorLun, KS
 
dc.contributor.authorWong, SJ
 
dc.contributor.authorCheung, YF
 
dc.date.accessioned2012-10-30T06:08:28Z
 
dc.date.available2012-10-30T06:08:28Z
 
dc.date.issued2010
 
dc.description.abstractBackground: The increasing data suggest an association between chronic right ventricular (RV) and left ventricular (LV) dysfunction. We sought to determine the effect of temporary interruption of long-term RV pacing on LV function and mechanical dyssynchrony in children and young adults with complete heart block. Methods: Twelve patients aged 20.0 ± 7.4 years with congenital heart block (group I) and six patients aged 22.7 ± 11.0 years with surgically acquired heart block (group II) with RV pacing were studied. The pacing rate was reduced to less than patient's intrinsic heart rate and maintained for 5 minutes. The LV ejection fraction (EF), three-dimensional systolic dyssynchrony index (SDI), two-dimensional global longitudinal strain and strain rate, and Doppler-derived isovolumic acceleration before and after interruption of RV pacing were compared. Results: The LVEF and GLS increased while QRS duration decreased after the pacing interruption in both the groups (all P < 0.05). While SDI decreased in both groups I (6.8 ± 2.3% - 3.8 ± 0.8%, P = 0.001) and II (9.2 ± 4.1%- 5.0 ± 1.6%, P = 0.032), it remained higher in group II than in group I (P = 0.046) after the pacing interruption. The prevalence of LV dyssynchrony (SDI > 4.7%) decreased in group I (83%- 25%, P = 0.006) but not in group II (67%- 50%, P = 0.50). The %increase in LVEF correlated positively with %reduction of LV SDI (r = 0.80, P = 0.001). Conclusions: Temporary interruption of chronic RV pacing acutely improves LV dyssynchrony and systolic function in children and young adults, the magnitude of which is greater in patients with congenital than those with surgically acquired heart block. (PACE 2010; 41-48) © 2009 Wiley Periodicals, Inc.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2010, v. 33 n. 1, p. 41-48 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1540-8159.2009.02574.x
 
dc.identifier.citeulike6468150
 
dc.identifier.doihttp://dx.doi.org/10.1111/j.1540-8159.2009.02574.x
 
dc.identifier.epage48
 
dc.identifier.hkuros168499
 
dc.identifier.issn0147-8389
2013 Impact Factor: 1.250
 
dc.identifier.issue1
 
dc.identifier.pmid19804489
 
dc.identifier.scopuseid_2-s2.0-73649093457
 
dc.identifier.spage41
 
dc.identifier.urihttp://hdl.handle.net/10722/170429
 
dc.identifier.volume33
 
dc.languageeng
 
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
 
dc.publisher.placeUnited States
 
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiology
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshCardiac Pacing, Artificial
 
dc.subject.meshEchocardiography
 
dc.subject.meshEchocardiography, Doppler, Color
 
dc.subject.meshEchocardiography, Three-Dimensional
 
dc.subject.meshElectrocardiography
 
dc.subject.meshFemale
 
dc.subject.meshHeart Block - Congenital - Therapy
 
dc.subject.meshHumans
 
dc.subject.meshMale
 
dc.subject.meshVentricular Dysfunction, Left - Etiology
 
dc.subject.meshVentricular Function, Left - Physiology
 
dc.subject.meshYoung Adult
 
dc.titleImpact of temporary interruption of right ventricular pacing for heart block on left ventricular function and dyssynchrony
 
dc.typeArticle
 
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<description.abstract>Background: The increasing data suggest an association between chronic right ventricular (RV) and left ventricular (LV) dysfunction. We sought to determine the effect of temporary interruption of long-term RV pacing on LV function and mechanical dyssynchrony in children and young adults with complete heart block. Methods: Twelve patients aged 20.0 &#177; 7.4 years with congenital heart block (group I) and six patients aged 22.7 &#177; 11.0 years with surgically acquired heart block (group II) with RV pacing were studied. The pacing rate was reduced to less than patient&apos;s intrinsic heart rate and maintained for 5 minutes. The LV ejection fraction (EF), three-dimensional systolic dyssynchrony index (SDI), two-dimensional global longitudinal strain and strain rate, and Doppler-derived isovolumic acceleration before and after interruption of RV pacing were compared. Results: The LVEF and GLS increased while QRS duration decreased after the pacing interruption in both the groups (all P &lt; 0.05). While SDI decreased in both groups I (6.8 &#177; 2.3% - 3.8 &#177; 0.8%, P = 0.001) and II (9.2 &#177; 4.1%- 5.0 &#177; 1.6%, P = 0.032), it remained higher in group II than in group I (P = 0.046) after the pacing interruption. The prevalence of LV dyssynchrony (SDI &gt; 4.7%) decreased in group I (83%- 25%, P = 0.006) but not in group II (67%- 50%, P = 0.50). The %increase in LVEF correlated positively with %reduction of LV SDI (r = 0.80, P = 0.001). Conclusions: Temporary interruption of chronic RV pacing acutely improves LV dyssynchrony and systolic function in children and young adults, the magnitude of which is greater in patients with congenital than those with surgically acquired heart block. (PACE 2010; 41-48) &#169; 2009 Wiley Periodicals, Inc.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong