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Acute Changes in Cardiac Synchrony and Output According to RV Pacing Sites in Koreans with Normal Cardiac Function
Author(s) -
Yoon Hee Jeoung,
Jin Seung Won,
Her Sung Ho,
Lee Jong Min,
Shin Woo Seung,
Kim Ji Hoon,
Oh Yong Suk,
Lee Man Young,
Seung Ki Bae,
Rho Tai Ho,
Kim Jae Hyung
Publication year - 2009
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2008.00855.x
Subject(s) - medicine , cardiology , qrs complex , cardiac pacing , ventricular outflow tract , cardiac function curve , doppler echocardiography , interventricular septum , heart failure , diastole , ventricle , blood pressure
The synchrony of the pacing heart can be affected by the right ventricular (RV) pacing site and is crucial to cardiac function in pacemaker recipients. We evaluated the acute changes in cardiac synchrony according to the RV pacing sites in normal systolic functioning subjects with normal QRS. Methods: We conducted this study with 30 patients with the pacing in the RV apex (RVA), RV septum (RVS), and RV outflow tract (RVOT) in a sequential manner. Transthoracic echocardiography was conducted at rest and during pacing in order to measure interventricular and intraventricular dyssynchrony in all patients. Results: QRS duration (148.1 ± 12.8 ms) of RVA pacing was significantly shorter than that of RVS pacing (154.4 ± 14.1 ms, P < 0.01) and RVOT pacing (160.6 ± 15.7 ms, P < 0.001). We noted no statistically significant difference in cardiac output according to the pacing sites. The interventricular dyssynchrony with M‐mode and Doppler echocardiography in RVOT pacing was increased to an insignificant degree as compared with those with RVS pacing or RVA pacing. The intraventricular dyssynchrony with tissue Doppler echocardiography in RVA pacing was reduced significantly as compared with that of RVS pacing or RVOT (RVA = 60.3 ± 32.7 ms, RVS = 82.1 ± 33.8 ms, RVOT = 79.1 ± 33.3 ms; RVA vs RVS = P < 0.05, RVA vs RVOT = P < 0.01, RVS vs RVOT = P = NS). Conclusion: RVA pacing is superior to RVS and RVOT pacing with regard to intraventricular synchrony in normal systolic functioning subjects with normal QRS. Cardiac output at RVA pacing is not inferior to other sites. (ECHOCARDIOGRAPHY, Volume 26, July 2009)