Comparison between endocardial and epicardial cardiac resynchronization in an experimental model of non-ischaemic cardiomyopathy.
Europace
; 20(7): 1209-1216, 2018 07 01.
Article
en En
| MEDLINE
| ID: mdl-29016778
ABSTRACT
Aims:
Pacing from the left ventricular (LV) endocardium might increase the likelihood of response to cardiac resynchronization therapy. However, experimental and clinical data supporting this assumption are limited and controversial. The aim of this study was to compare the acute response of biventricular pacing from the LV epicardium and endocardium in a swine non-ischaemic cardiomyopathy (NICM) model of dyssynchrony. Methods andresults:
A NICM was induced in six swine by 3 weeks of rapid ventricular pacing. Biventricular stimulation was performed from 16 paired locations in the LV (8 epicardial and 8 endocardial) with two different atrioventricular (80 and 110 ms) intervals and three interventricular (0, +30, -30 ms) delays. The acute response of the aortic blood flow, LV and right ventricular (RV) pressures, LVdP/dtmax and LVdP/dtmin and QRS complex width and QT duration induced by biventricular stimulation were analysed. The haemodynamic and electrical beneficial responses to either LV endocardial or epicardial biventricular pacing were similar (ΔLVdP/dtmax +7.8 ± 2.2% ENDO vs. +7.3 ± 1.5% EPI, and ΔQRS width -16.8 ± 1.3% ENDO vs. -17.1 ± 1.9% EPI; P = ns). Pacing from LV basal regions either from the epicardium or endocardium produced better haemodynamic responses as compared with mid or apical LV regions (P < 0.05). The LV regions producing the maximum QRS complex shortening did not correspond to those inducing the best haemodynamic responses (EPI r2 = 0.013, P = ns; ENDO r2 = 0.002, P = ns).Conclusion:
Endocardial LV pacing induced similar haemodynamic changes than pacing from the epicardium. The response to endocardial LV pacing is region dependent as observed in epicardial pacing.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Pericardio
/
Arritmias Cardíacas
/
Función Ventricular Izquierda
/
Función Ventricular Derecha
/
Endocardio
/
Terapia de Resincronización Cardíaca
/
Insuficiencia Cardíaca
/
Cardiomiopatías
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Límite:
Animals
Idioma:
En
Revista:
Europace
Asunto de la revista:
CARDIOLOGIA
/
FISIOLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
España