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Atrial Pacing Lead Location Alters the Hemodynamic Effects of Atrial‐Ventricular Delay in Dogs with Pacing Induced Cardiomyopathy
Author(s) -
HETTRICK DOUGLAS A.,
MITTELSTADT JACQUELINE R.,
KEHL FRANZ,
KRESS TOBIAS T.,
TESSMER JOHN P.,
KROLIKOWSKI JOHN G.,
KERSTEN JUDY R.,
WARLTIER DAVID C.,
PAGEL PAUL S.
Publication year - 2003
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2003.t01-1-00150.x
Subject(s) - medicine , preload , cardiology , hemodynamics , coronary sinus , central venous pressure , stroke volume , cardiac output , dilated cardiomyopathy , anesthesia , blood pressure , heart rate , heart failure
HETTRICK, D.A., et al .: Atrial Pacing Lead Location Alters the Hemodynamic Effects of Atrial Ventricular Delay in Dogs with Pacing Induced Cardiomyopathy.The role of atrial lead location in cardiovascular function in the presence of impaired ventricular dysfunction is unknown. We tested the hypothesis that left atrial (LA) and left ventricular (LV) hemodynamics are affected by alterations in AV delay and are influenced by atrial pacing site in dogs with dilated cardiomyopathy. Dogs(n = 7)were chronically paced at 220 beats/min for 3 weeks to produce cardiomyopathy and then instrumented for measurement of LA, LV end diastolic pressure (LVEDP) and mean arterial pressure (MAP), LA volume, LV short‐axis diameter, and aortic and pulmonary venous blood flow. Hemodynamics were measured after instrumentation and during atrial overdrive pacing from the right atrial appendage (RAA), coronary sinus ostium (CSO) and lower LA lateral wall (LAW). The AV node was then ablated, and hemodynamics were compared during dual chamber AV pacing (right ventricular apex) from each atrial lead location at several AV delays between 20 and 350 ms. Atrial overdrive pacing from different sites did not alter hemodynamics. Cardiac output (CO), stroke volume, LVEDP, MAP and +dLVP/dt demonstrated significant (P < 0.05) variation with AV delay during dual chamber pacing. CO was higher during LAW pacing than RAA and CSO pacing (2.3 ± 0.4vs2.1 ± 0.3vs2.0 ± 0.3 l/min, respectively) at an AV delay of 120 ms. Also, MAP was higher in the LAW than RAA and CSO (65 ± 9vs59 ± 9vs54 ± 11 mmHg, respectively) at an AV delay of 350 ms. Atrial lead location affects indices of LV performance independent of AV delay during dual chamber pacing in dogs with cardiomyopathy. (PACE 2003; 26[Pt. I]:853–861)