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Article: Functional abnormalities in patients with permanent right ventricular pacing: The effect of sites of electrical stimulation

TitleFunctional abnormalities in patients with permanent right ventricular pacing: The effect of sites of electrical stimulation
Authors
Issue Date2002
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jac
Citation
Journal Of The American College Of Cardiology, 2002, v. 40 n. 8, p. 1451-1458 How to Cite?
AbstractOBJECTIVES: We sought to evaluate the long-term effects of alternative right ventricular pacing sites on myocardial function and perfusion. BACKGROUND: Previous studies have demonstrated that asynchronous ventricular activation due to right ventricular apical (RVA) pacing alters regional myocardial perfusion and functions. METHODS: We randomized 24 patients with complete atrioventricular block to undergo permanent ventricular stimulation either at the RVA (n = 12) or right ventricular outflow (RVOT) (n = 12). All patients underwent dipyridamole thallium myocardial scintigraphy and radionuclide ventriculography at 6 and 18 months after pacemaker implantation. RESULTS; After pacing, the mean QRS duration was significantly longer during RVA pacing than during RVOT pacing (151 ± 6 vs. 134 ± 4 ms, p = 0.03). At six months, the incidence of myocardial perfusion defects (50% vs. 25%) and regional wall motion abnormalities (42% vs. 25%) and the left ventricular ejection fraction (LVEF) (55 ± 3% vs. 55 ± 1%) were similar during RVA pacing and RVOT pacing (p > 0.05). However, at 18 months, the incidence of myocardial perfusion defects (83% vs. 33%) and regional wall motion abnormalities (75% vs. 33%) were higher and LVEF (47 ± 3 vs. 56 ± 1%) was lower during RVA pacing than during RVOT pacing (all p < 0.05). Patients with RVA pacing had a significant increase in the incidence of myocardial perfusion defects (p < 0.05) and a decrease in LVEF (p < 0.01) between 6 and 18 months, but patients with RVOT pacing did not (p > 0.05). CONCLUSIONS: This study demonstrates that preserved synchronous ventricular activation with RVOT pacing prevents the long-term deleterious effects of RVA pacing on myocardial perfusion and function in patients implanted with a permanent © 2002 by the American College of Cardiology Foundation.
Persistent Identifierhttp://hdl.handle.net/10722/78458
ISSN
2015 Impact Factor: 17.759
2015 SCImago Journal Rankings: 10.097
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorYu, Cen_HK
dc.contributor.authorWong, KKen_HK
dc.contributor.authorTsang, Ven_HK
dc.contributor.authorLeung, YLen_HK
dc.contributor.authorHo, WYen_HK
dc.contributor.authorLau, CPen_HK
dc.date.accessioned2010-09-06T07:43:07Z-
dc.date.available2010-09-06T07:43:07Z-
dc.date.issued2002en_HK
dc.identifier.citationJournal Of The American College Of Cardiology, 2002, v. 40 n. 8, p. 1451-1458en_HK
dc.identifier.issn0735-1097en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78458-
dc.description.abstractOBJECTIVES: We sought to evaluate the long-term effects of alternative right ventricular pacing sites on myocardial function and perfusion. BACKGROUND: Previous studies have demonstrated that asynchronous ventricular activation due to right ventricular apical (RVA) pacing alters regional myocardial perfusion and functions. METHODS: We randomized 24 patients with complete atrioventricular block to undergo permanent ventricular stimulation either at the RVA (n = 12) or right ventricular outflow (RVOT) (n = 12). All patients underwent dipyridamole thallium myocardial scintigraphy and radionuclide ventriculography at 6 and 18 months after pacemaker implantation. RESULTS; After pacing, the mean QRS duration was significantly longer during RVA pacing than during RVOT pacing (151 ± 6 vs. 134 ± 4 ms, p = 0.03). At six months, the incidence of myocardial perfusion defects (50% vs. 25%) and regional wall motion abnormalities (42% vs. 25%) and the left ventricular ejection fraction (LVEF) (55 ± 3% vs. 55 ± 1%) were similar during RVA pacing and RVOT pacing (p > 0.05). However, at 18 months, the incidence of myocardial perfusion defects (83% vs. 33%) and regional wall motion abnormalities (75% vs. 33%) were higher and LVEF (47 ± 3 vs. 56 ± 1%) was lower during RVA pacing than during RVOT pacing (all p < 0.05). Patients with RVA pacing had a significant increase in the incidence of myocardial perfusion defects (p < 0.05) and a decrease in LVEF (p < 0.01) between 6 and 18 months, but patients with RVOT pacing did not (p > 0.05). CONCLUSIONS: This study demonstrates that preserved synchronous ventricular activation with RVOT pacing prevents the long-term deleterious effects of RVA pacing on myocardial perfusion and function in patients implanted with a permanent © 2002 by the American College of Cardiology Foundation.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jacen_HK
dc.relation.ispartofJournal of the American College of Cardiologyen_HK
dc.rightsJournal of American College of Cardiology. Copyright © Elsevier Inc.en_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshCardiac Pacing, Artificialen_HK
dc.subject.meshCoronary Circulationen_HK
dc.subject.meshDipyridamole - diagnostic useen_HK
dc.subject.meshElectrocardiographyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHeart Block - physiopathology - radionuclide imaging - therapyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPacemaker, Artificialen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshRadionuclide Ventriculographyen_HK
dc.subject.meshThallium Radioisotopes - diagnostic useen_HK
dc.subject.meshTomography, Emission-Computed, Single-Photonen_HK
dc.subject.meshVasodilator Agents - diagnostic useen_HK
dc.titleFunctional abnormalities in patients with permanent right ventricular pacing: The effect of sites of electrical stimulationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0735-1097&volume=40 &issue=8&spage=1451&epage=8&date=2002&atitle=Functional+Abnormalities+in+Patients+with+Permanent+Right+Ventricular+Pacing:+the+Effect+of+Sites+of+Electrical+Stimulation.en_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0735-1097(02)02169-1en_HK
dc.identifier.pmid12392836-
dc.identifier.scopuseid_2-s2.0-0037120960en_HK
dc.identifier.hkuros81914en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037120960&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume40en_HK
dc.identifier.issue8en_HK
dc.identifier.spage1451en_HK
dc.identifier.epage1458en_HK
dc.identifier.isiWOS:000178600000013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridYu, C=7404978038en_HK
dc.identifier.scopusauthoridWong, KK=7404758873en_HK
dc.identifier.scopusauthoridTsang, V=7005694255en_HK
dc.identifier.scopusauthoridLeung, YL=36894862100en_HK
dc.identifier.scopusauthoridHo, WY=25938053100en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK

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