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Article: Effects of right low atrial septal vs. right atrial appendage pacing on atrial mechanical function and dyssynchrony in patients with sinus node dysfunction and paroxysmal atrial fibrillation

TitleEffects of right low atrial septal vs. right atrial appendage pacing on atrial mechanical function and dyssynchrony in patients with sinus node dysfunction and paroxysmal atrial fibrillation
Authors
Issue Date2011
PublisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/
Citation
Europace, 2011, v. 13 n. 9, p. 1268-1274 How to Cite?
Abstract
AIMS: To study the effects of right low atrial septum (AS) and right atrial appendage (RAA) pacing on atrial mechanical function and dyssynchrony in patients with sinus node disease (SND) and paroxysmal atrial fibrillation (AF). METHODS AND RESULTS: Detailed echocardiographic examination was performed on 30 patients with SND and paroxysmal AF and a dual-chamber, dual sensing, dual response pacemaker with atrial lead implantation at AS(n= 15) or RAA(n= 15). Peak atrial velocities were recorded by pulsed tissue Doppler spectrum. The timing of atrial contractions (Ta) was measured at the middle of the left atrial (LA) and right atrial (RA) free wall. Intra-[standard deviation (SD) of time of Ta (Ta-SD)] and inter-atrial delay(Ta-RL) was measured as the SD of time interval among LA six segments and time difference between the LA and RA wall, respectively. The baseline clinical statuses were similar between groups. Indexes of LA function, and intra- or inter-atrial dyssynchrony were also similar during intrinsic sinus rhythm in both groups (all P> 0.05). During atrial pacing, LA ejection fraction (52 +/- 16 vs. 39 +/- 14%, P= 0.029) and LA active emptying fraction (34 +/- 7 vs. 23 +/- 15%, P= 0.012) were higher in patients with AS than RAA pacing. Atrial velocity was also higher at the RA free wall (14.3 +/- 3.1 vs. 10.3 +/- 4.4 cm/s, P= 0.009), LA septal (7.5 +/- 2.1 vs. 5.2 +/- 1.7 cm/s, P= 0.004) and lateral wall (8.6 +/- 2.4 vs. 6.3 +/- 3.0 cm/s, P= 0.024) during AS compared with RAA pacing. There was no difference in Ts-SD during atrial pacing, nevertheless Ta-RL was significantly prolonged in patients with RAA compared with those with AS pacing (42 +/- 36 vs. 27 +/- 25 ms, P= 0.011). CONCLUSION: In patients with SND and paroxysmal AF, right low AS pacing significantly improved global and regional atrial mechanical function and synchronized inter-atrial electromechanical contraction compared with RAA pacing.
Persistent Identifierhttp://hdl.handle.net/10722/76887
ISSN
2013 Impact Factor: 3.050
ISI Accession Number ID
Funding AgencyGrant Number
Research Grant Council of Hong KongHKU 7777/07M
HKU 7775/08M
Funding Information:

This study was supported by General Research Fund of Research Grant Council of Hong Kong (HKU 7777/07M and HKU 7775/08M).

References

 

Author Affiliations
  1. The University of Hong Kong Li Ka Shing Faculty of Medicine
  2. The University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorWang, Men_HK
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorLee, KLFen_HK
dc.contributor.authorYue, WSen_HK
dc.contributor.authorYan, GHen_HK
dc.contributor.authorLee, Sen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorTse, HFen_HK
dc.date.accessioned2010-09-06T07:25:59Z-
dc.date.available2010-09-06T07:25:59Z-
dc.date.issued2011en_HK
dc.identifier.citationEuropace, 2011, v. 13 n. 9, p. 1268-1274en_HK
dc.identifier.issn1099-5129en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76887-
dc.description.abstractAIMS: To study the effects of right low atrial septum (AS) and right atrial appendage (RAA) pacing on atrial mechanical function and dyssynchrony in patients with sinus node disease (SND) and paroxysmal atrial fibrillation (AF). METHODS AND RESULTS: Detailed echocardiographic examination was performed on 30 patients with SND and paroxysmal AF and a dual-chamber, dual sensing, dual response pacemaker with atrial lead implantation at AS(n= 15) or RAA(n= 15). Peak atrial velocities were recorded by pulsed tissue Doppler spectrum. The timing of atrial contractions (Ta) was measured at the middle of the left atrial (LA) and right atrial (RA) free wall. Intra-[standard deviation (SD) of time of Ta (Ta-SD)] and inter-atrial delay(Ta-RL) was measured as the SD of time interval among LA six segments and time difference between the LA and RA wall, respectively. The baseline clinical statuses were similar between groups. Indexes of LA function, and intra- or inter-atrial dyssynchrony were also similar during intrinsic sinus rhythm in both groups (all P> 0.05). During atrial pacing, LA ejection fraction (52 +/- 16 vs. 39 +/- 14%, P= 0.029) and LA active emptying fraction (34 +/- 7 vs. 23 +/- 15%, P= 0.012) were higher in patients with AS than RAA pacing. Atrial velocity was also higher at the RA free wall (14.3 +/- 3.1 vs. 10.3 +/- 4.4 cm/s, P= 0.009), LA septal (7.5 +/- 2.1 vs. 5.2 +/- 1.7 cm/s, P= 0.004) and lateral wall (8.6 +/- 2.4 vs. 6.3 +/- 3.0 cm/s, P= 0.024) during AS compared with RAA pacing. There was no difference in Ts-SD during atrial pacing, nevertheless Ta-RL was significantly prolonged in patients with RAA compared with those with AS pacing (42 +/- 36 vs. 27 +/- 25 ms, P= 0.011). CONCLUSION: In patients with SND and paroxysmal AF, right low AS pacing significantly improved global and regional atrial mechanical function and synchronized inter-atrial electromechanical contraction compared with RAA pacing.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/en_HK
dc.relation.ispartofEuropaceen_HK
dc.subject.meshAtrial Appendage - physiopathology - ultrasonography-
dc.subject.meshAtrial Fibrillation - physiopathology - therapy - ultrasonography-
dc.subject.meshAtrial Septum - physiopathology - ultrasonography-
dc.subject.meshCardiac Pacing, Artificial-
dc.subject.meshSick Sinus Syndrome - physiopathology - ultrasonography-
dc.titleEffects of right low atrial septal vs. right atrial appendage pacing on atrial mechanical function and dyssynchrony in patients with sinus node dysfunction and paroxysmal atrial fibrillationen_HK
dc.typeArticleen_HK
dc.identifier.emailWang, M: meiwang@hkucc.hku.hken_HK
dc.identifier.emailSiu, CW: cwdsiu@hkucc.hku.hken_HK
dc.identifier.emailYan, GH: guohui@hkucc.hku.hken_HK
dc.identifier.emailLee, S: drsl@hkucc.hku.hk-
dc.identifier.emailLau, CP: cplau@hku.hk-
dc.identifier.emailTse, HF: hftse@hkucc.hku.hk-
dc.identifier.authorityWang, M=rp00281en_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_OA_fulltexten_HK
dc.identifier.doi10.1093/europace/eur110en_HK
dc.identifier.pmid21515592en_HK
dc.identifier.scopuseid_2-s2.0-80052203448en_HK
dc.identifier.hkuros208717en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80052203448&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume13en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1268en_HK
dc.identifier.epage1274en_HK
dc.identifier.isiWOS:000294440000012-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridLee, S=7601396808en_HK
dc.identifier.scopusauthoridYan, GH=36544693600en_HK
dc.identifier.scopusauthoridYue, WS=36106565300en_HK
dc.identifier.scopusauthoridLee, KL=7501505962en_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridWang, M=7406690398en_HK
dc.identifier.citeulike9312469-

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