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Article: Impact of temporary interruption of right ventricular pacing for heart block on left ventricular function and dyssynchrony

TitleImpact of temporary interruption of right ventricular pacing for heart block on left ventricular function and dyssynchrony
Authors
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
Citation
Pace - Pacing And Clinical Electrophysiology, 2010, v. 33 n. 1, p. 41-48 How to Cite?
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 ± 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.
Persistent Identifierhttp://hdl.handle.net/10722/170429
ISSN
2013 Impact Factor: 1.250
ISI Accession Number ID
References

 

Author Affiliations
  1. The University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorHong, WJen_US
dc.contributor.authorYung, TCen_US
dc.contributor.authorLun, KSen_US
dc.contributor.authorWong, SJen_US
dc.contributor.authorCheung, YFen_US
dc.date.accessioned2012-10-30T06:08:28Z-
dc.date.available2012-10-30T06:08:28Z-
dc.date.issued2010en_US
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2010, v. 33 n. 1, p. 41-48en_US
dc.identifier.issn0147-8389en_US
dc.identifier.urihttp://hdl.handle.net/10722/170429-
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.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_US
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_US
dc.subject.meshCardiac Pacing, Artificialen_US
dc.subject.meshEchocardiographyen_US
dc.subject.meshEchocardiography, Doppler, Coloren_US
dc.subject.meshEchocardiography, Three-Dimensionalen_US
dc.subject.meshElectrocardiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Block - Congenital - Therapyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshVentricular Dysfunction, Left - Etiologyen_US
dc.subject.meshVentricular Function, Left - Physiologyen_US
dc.subject.meshYoung Adulten_US
dc.titleImpact of temporary interruption of right ventricular pacing for heart block on left ventricular function and dyssynchronyen_US
dc.typeArticleen_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1540-8159.2009.02574.xen_US
dc.identifier.pmid19804489en_US
dc.identifier.scopuseid_2-s2.0-73649093457en_US
dc.identifier.hkuros168499-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-73649093457&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume33en_US
dc.identifier.issue1en_US
dc.identifier.spage41en_US
dc.identifier.epage48en_US
dc.identifier.isiWOS:000273167700009-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridHong, WJ=14010481700en_US
dc.identifier.scopusauthoridYung, TC=9132842300en_US
dc.identifier.scopusauthoridLun, KS=8363663600en_US
dc.identifier.scopusauthoridWong, SJ=25924109100en_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US
dc.identifier.citeulike6468150-

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