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Journal of Cardiovascular Translational Research

Erschienen in:

01.06.2013

Further Deterioration of LV Ejection Fraction and Mechanical Synchrony During RV Apical Pacing in Patients with Heart Failure and LBBB

verfasst von: Daniel R. Ludwig, Hidekazu Tanaka, Mati Friehling, John Gorcsan III, David Schwartzman

Erschienen in: Journal of Cardiovascular Translational Research | Ausgabe 3/2013

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Abstract

Electrocardiographic left bundle branch block (LBBB) may be due to intrinsic disease of the left bundle branch or induced by right ventricular apical (RVA) pacing. Prior reports clearly delineate the derogatory impact of LBBB on left ventricular (LV) mechanical function but suggest equivalent impact between varieties. We hypothesized that their effects were disparate and performed a within-patient comparison to test this notion. Patients (n = 20) with heart failure, intrinsic LBBB, and an implanted pacing device with right atrial and RVA leads were studied. Each patient underwent transthoracic three-dimensional speckle-tracking echocardiography during atrial pacing (intrinsic LBBB) and short atrioventricular delay atrial-RVA pacing, and these studies were compared. Relative to intrinsic LBBB, RVA pacing-induced LBBB produced greater intra-LV and interventricular dyssynchrony, a deterioration in LV function, and a shift in the site of latest activation. In patients with heart failure and LBBB, acute RVA pacing induces greater mechanical dyssynchrony and further impairs LV function.

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Titel: Further Deterioration of LV Ejection Fraction and Mechanical Synchrony During RV Apical Pacing in Patients with Heart Failure and LBBB
verfasst von: Daniel R. Ludwig
Hidekazu Tanaka
Mati Friehling
John Gorcsan III
David Schwartzman
Publikationsdatum: 01.06.2013
Verlag: Springer US
Erschienen in: Journal of Cardiovascular Translational Research / Ausgabe 3/2013
Print ISSN: 1937-5387
Elektronische ISSN: 1937-5395
DOI: https://doi.org/10.1007/s12265-013-9457-0

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Further Deterioration of LV Ejection Fraction and Mechanical Synchrony During RV Apical Pacing in Patients with Heart Failure and LBBB

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