Analysis of dyssynchrony and ventricular function in right univentricular stimulation at different positions
Rev. bras. cir. cardiovasc
; 32(6): 492-497, Nov.-Dec. 2017. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-897955
Biblioteca responsável:
BR1.1
ABSTRACT
Abstract Introduction:
Chronic stimulation of the right ventricle with pacemaker is associated with ventricular dyssynchrony and loss of contractility, even in subjects without previous dysfunction. In these patients, there is a debate of which pacing site is less associated with loss of ventricular function.Objective:
To compare pacemaker-induced dyssynchrony among different pacing sites in right ventricular stimulation.Methods:
Cross-sectional study of outpatients with right ventricle stimulation higher than 80% and preserved left ventricular ejection fraction. Pacing lead position (apical, medial septum or free wall) was assessed through chest X-rays. Every patient underwent echocardiogram to evaluate for dyssynchrony according to CARE-HF criteria aortic pre-ejection time, interventricular delay and septum/posterior wall delay on M mode.Results:
Forty patients were included. Fifty-two percent had apical electrode position, 42% mid septum and 6% free wall. Mean QRS time 148.97±15.52 milliseconds. A weak correlation between the mean QRS width and pre-aortic ejection time (r=0.32; P=0.04) was found. No difference in QRS width among the positions could be noted. Intraventricular delay was lower in apical patients against mid septal (34.4±17.2 vs. 54.3±19.1 P<0.05) - no difference with those electrode on the free wall. No difference was noted in the pre-aortic ejection time (P=0.9).Conclusion:
Apical pacing showed a lower interventricular conduction delay when compared to medial septum site. Our findings suggest that apical pacing dyssynchrony is not ubiquitous, as previously thought, and that it should remain an option for lead placement.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Marca-Passo Artificial
/
Estimulação Cardíaca Artificial
/
Disfunção Ventricular Direita
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo de prevalência
/
Fatores de risco
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
Cardiologia
/
CIRURGIA GERAL
Ano de publicação:
2017
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Fundação Universitária de Cardiologia/BR