Analysis of Dyssynchrony and Ventricular Function in Right Univentricular Stimulation at Different Positions

Osório, Ana Paula Susin; Neto, Stefan Warpechowski; Ley, Antonio Lessa Gaudie; Miglioranza, Marcelo Haertel; Ley, Laura; Almeida, Eduardo Dytz; Sant’Anna, Roberto T.; Leiria, Tiago Luiz Luz

doi:10.21470/1678-9741-2017-0056

Cited by 5 publications

(5 citation statements)

References 21 publications

(20 reference statements)

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“…The effects of right ventricular septal pacing in terms of maintaining ventricular synchrony and cardiac function are still controversial. [13][14][15][16][17][18] With the rapid development of technology, many studies have confirmed the advantage of left bundle branch area pacing. Studies proved that left bundle branch area pacing produces narrower-paced QRS duration and better echocardiographic cardiac function than does right ventricular septal pacing.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ventricular synchrony in children with left bundle branch area pacing and right ventricular septal pacing

Jiang

Cui

et al. 2023

Cardiol Young

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Objective: This study aimed to determine the ideal pacing site in children by comparing the postoperative ventricular synchrony in children with left bundle branch area pacing and those with right ventricular septal pacing. Methods: This retrospective study included children with complete atrioventricular block who underwent permanent pacemaker implantation from March 2019 to August 2021. Patients were grouped according to their ventricular pacing site, the left bundle branch area pacing group and the right ventricular septal pacing group. Two-dimensional speckle tracking echocardiography was used to evaluate the ventricular synchrony. Results: Forty-eight children (median age, 2.7 years; interquartile range, 1.7–4.6 years) were included. The paced QRS duration in the left bundle branch area pacing group was significantly narrower than that in the right ventricular septal pacing group (100.2 ± 9.3 versus 115.4 ± 15.1 ms, p = 0.001). The median follow-up duration was 1.5 years (interquartile range, 1–2 years). At the last follow-up, the average capture threshold of the ventricular electrode in the left bundle branch area pacing group was lower than that in the right ventricular septal pacing group (0.79 ± 0.18 versus 1.20 ± 0.56 V, p = 0.008). The left ventricular intraventricular synchrony parameters in the left bundle branch area pacing group were better than those in the right ventricular septal pacing group (e.g. standard deviation of the time to peak longitudinal strain, 37.4 ± 4.3 versus 46.6 ± 8.2 ms, p = 0.000). The average interventricular mechanical delay time in the left bundle branch area pacing group was significantly shorter than that in the right ventricular septal pacing group (36.4 ± 14.2 versus 52.5 ± 22.7 ms, p = 0.016). Conclusion: Compared with right ventricular septal pacing, left bundle branch area pacing in children produces a narrower QRS duration and better pacing and ventricular synchrony parameters postoperatively.

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Section: Discussionmentioning

confidence: 99%

Comparison of ventricular synchrony in children with left bundle branch area pacing and right ventricular septal pacing

Jiang

Cui

et al. 2023

Cardiol Young

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“…Основными местами позиционирования электродов являются апикальная и септальная позиции, при этом часть исследователей [10,11] отдают предпочтение апикальному расположению. По данным C. Gerald et al [12], размещение электрода в септальной позиции имеет эффективность, схожую с эффективностью при апикальном размещении.…”

Section: выбор икд и позиционирования электродовunclassified

Implantable cardioverter defibrillators for the prevention of sudden cardiac death: technical aspects and future perspectives. What a practitioner needs to know?

Talibullin¹,

Lebedeva²,

Parfenov³

et al. 2022

Russian Medical Inquiry

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Currently, the prevention of sudden cardiac death (SCD) is an urgent issue as never, i.e., more than a half of patients with cardiovascular disorders die suddenly, one third of patients are young and middle-aged adults. The primary preventive strategy of SCD is an implantable cardioverter defibrillator (ICD) due to the lack of highly effective and, more important, safe antiarrhythmics. Forty years after the first ICD insertion, SCD is still the cause of more than 5 million of deaths annually worldwide. Therefore, a real need for ICD is significantly higher than the number of insertions. Meanwhile, primary physicians are not aware of this preventive tool. This paper reviews current approaches to ICD use for the primary and secondary prevention of SCD, types of ICDs, selection of electrode insertion sites, relevant aspects of ICD programming to detect and addresses arrhythmias by antitachycardial pacing or shock discharge, standards for outpatient follow-up after ICD insertion, distant monitoring and telemetry, and future perspectives of ICD insertion. KEYWORDS: sudden cardiac death, implantable cardioverter defibrillator, distant monitoring, perspectives. FOR CITATION: Talibullin I.V., Lebedeva N.B., Parfenov P.G., Mamchur S.E. Implantable cardioverter defibrillators for the prevention of sudden cardiac death: technical aspects and future perspectives. What a practitioner needs to know? Russian Medical Inquiry. 2022;6(1):21– 25 (in Russ.). DOI: 10.32364/2587-6821-2022-6-1-21-25.

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“…The degree of electrical dyssynchrony induced by right ventricular pacing can be calculated by the duration of the paced QRS. However, Osório, et al found that QRS complex duration did not correlate well with pacing position and correlated poorly with dyssynchrony parameters . The use of variable echocardiographic modalities to assess the ventricular dyssynchrony is very important especially using tissue Doppler imaging (TDI) and 2D speckle tracking echocardiography .…”

Section: Introductionmentioning

confidence: 98%

Ventricular Dyssynchrony based on echocardiographic variables and exercise tolerance After right ventricular pacing: Impact of alternative septal lead locations

et al. 2020

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Objective We investigated the impact of alternative locations of right ventricular (RV) pacing on left ventricular function and its relation to exercise capacity. Methods Fifty patients who received a single lead pacemaker were divided according to RV pacing site into group 1 "high septum" (n = 15), group 2 "mid‐septum" (n = 25), and group 3 "low septum" (n = 10) using a documented fluoroscopic method. Dyssynchrony parameters were obtained using different echocardiographic parameters. Their exercise tolerance was evaluated after 6 months of pacemaker implantation using 6 minutes walk test (6 MWT). Results We found a lesser degree of dyssynchrony in mid‐location and high location compared with low location pacing (radial dyssynchrony: P < .001; maximum temporal difference: P < .01; inter‐ventricular mechanical delay: P < .05, standard deviation of time‐to‐peak strain by tissue Doppler: P < .05). Sm was significantly increased 6 months following pacemaker implantation in group 1 and group 2 in contrast to group 3 patients (P < .05). Importantly, E/e' increased significantly (P < .001) in patients with low septal location pacing. Furthermore, 6 MWT distance was significantly improved (P < .001) in favor of groups 1 and 2. Importantly, the intra‐ventricular dyssynchrony with speckle tracking was considerably less in group 1 and 2 patients. Tps‐SL ≤ 120 ms was the optimal value to predict improvement in functional capacity following high to mid‐septal pacing locations. Conclusion There was significant improvement of functional capacity after RV pacing in high and mid‐septal locations compared with low septal location. This was associated with a lesser degree of dyssynchrony in favor with mid‐ to high septal location.

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Analysis of Dyssynchrony and Ventricular Function in Right Univentricular Stimulation at Different Positions

Cited by 5 publications

References 21 publications

Comparison of ventricular synchrony in children with left bundle branch area pacing and right ventricular septal pacing

Comparison of ventricular synchrony in children with left bundle branch area pacing and right ventricular septal pacing

Implantable cardioverter defibrillators for the prevention of sudden cardiac death: technical aspects and future perspectives. What a practitioner needs to know?

Ventricular Dyssynchrony based on echocardiographic variables and exercise tolerance After right ventricular pacing: Impact of alternative septal lead locations

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