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
2011 Impact Factor: 1.351
2011 SCImago Journal Rankings: 0.157
DOIhttp://dx.doi.org/10.1111/j.1540-8159.2009.02574.x
ReferencesReferences in Scopus
DC Field
Value
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.issn0147-8389
2011 Impact Factor: 1.351
2011 SCImago Journal Rankings: 0.157
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
Author Affiliations
  1. The University of Hong Kong