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Reversal of Left Ventricular Remodeling by Synchronous Biventricular Pacing in Heart Failure
Author(s) -
LAU CHUPAK,
YU CHEUKMAN,
CHAU ELAINE,
FAN KATHRYN,
TSE HUNGFAT,
LEE KATHY,
TANG MANOI,
WAN SIUHONG,
LAW TINCHU,
LEE PUIYIN,
LAM YUIMING,
HILL MICHAEL R.S.
Publication year - 2000
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 - 10.1111/j.1540-8159.2000.tb07004.x
Subject(s) - medicine , cardiology , heart failure , ejection fraction , qrs complex , ventricular remodeling , mitral regurgitation , diastole , hemodynamics , blood pressure
Synchronous biventricular pacing is a new nonpharmacological supplemental treatment of advanced heart failure associated with electromechanical conduction delay. However, the role of pacing on left ventricular remodeling is unknown. Eleven patients with New York Heart Association Class III to IV heart failure, a left ventricular ejection fraction < 35%, and a QRS duration ≥ 140 ms received a biventricular dual chamber pacemaker. Serial echocardiography, 6‐minute hall walk, and Minnesota Living with Heart Failure quality‐of‐life (QOL) questionnaire were performed before and after up to 3 months of pacing. At 3 months there was a significant increase in fractional shortening (P < 0.001), ejection fraction (P < 0.001), and cardiac output (P < 0.05). The left ventricular end‐diastolic volume (245 ± 70 vs 185 ± 37 mL, P < 0.05), end‐systolic volume (209 ± 69 vs 140± 44 mLP < 0.05), and mitral regurgitation were reduced (P < 0.05), and diastolic filling time was lengthened (P < 0.05). There were also improvements in heart failure symptoms, an increase in 6‐minute walk distance, and a decrease in QOL scores. Synchronous biventricular pacing for 3 months was associated with hemodynamic improvements, reversal of left ventricular remodeling, and increase in left ventricular systolic function, and a decrease in secondary mitral regurgitation.