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Left ventricular and biventricular pacing in congestive heart failure.
Gerber, T C; Nishimura, R A; Holmes, D R; Lloyd, M A; Zehr, K J; Tajik, A J; Hayes, D L.
Affiliation
  • Gerber TC; Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
Mayo Clin Proc ; 76(8): 803-12, 2001 Aug.
Article in En | MEDLINE | ID: mdl-11499820
Dual-chamber pacing improved hemodynamics acutely in a subset of patients with left ventricular (LV) dysfunction but conveyed no long-term symptomatic benefit in most. More recently, LV pacing and biventricular (multisite) pacing have been used to improve systolic contractility by altering the electrical and mechanical ventricular activation sequence in patients with severe congestive heart failure (CHF) and intraventricular conduction delay or left bundle branch block (LBBB). Intraventricular conduction delay and LBBB cause dyssynchronous right ventricular and LV contraction and worsen LV dysfunction in cardiomyopathies. Both LV and biventricular cardiac pacing are thought to improve cardiac function in this situation by effecting a more coordinated and efficient ventricular contraction. Short-term hemodynamic studies have shown improvement in LV systolic function, which seems more pronounced with monoventricular LV pacing than with biventricular pacing. Recent clinical studies in limited numbers of patients suggest long-term clinical benefit of biventricular pacing in patients with severe CHF symptoms. Continuing and future studies will demonstrate whether and in which patients LV and biventricular pacing are permanently effective and equivalent and which pacing site within the LV produces the most beneficial hemodynamic results.
Subject(s)
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Collection: 01-internacional Database: MEDLINE Main subject: Pacemaker, Artificial / Cardiac Pacing, Artificial / Heart Failure / Heart Ventricles Limits: Humans Language: En Journal: Mayo Clin Proc Year: 2001 Document type: Article Affiliation country: Estados Unidos Country of publication: Reino Unido
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Collection: 01-internacional Database: MEDLINE Main subject: Pacemaker, Artificial / Cardiac Pacing, Artificial / Heart Failure / Heart Ventricles Limits: Humans Language: En Journal: Mayo Clin Proc Year: 2001 Document type: Article Affiliation country: Estados Unidos Country of publication: Reino Unido