Differences in pacing from the atrial appendage and the lateral atrial free wall on left ventricular filling and haemodynamics during DDD pacing

Campen, C. M. C. van; Cock, C. C. de; Kamp, Otto; Visser, C.A.

doi:10.1053/eupc.2000.0134

Cited by 9 publications

(7 citation statements)

References 8 publications

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“…Although there is some evidence in adults that for atrial synchronization septal pacing is advantageous compared to RAA pacing, 9 the body of evidence still suggests that RAA is acceptable and indeed may have an advantageous effect on cardiac output 10 . Based on the evidence to date, the RAA remained our position of choice for placement of all five atrial leads.…”

Section: Discussionmentioning

confidence: 99%

Noncatheter‐Based Delivery of a Single‐Chamber Lumenless Pacing Lead in Small Children

Kenny

Walsh²

2007

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 99%

Noncatheter‐Based Delivery of a Single‐Chamber Lumenless Pacing Lead in Small Children

Kenny

Walsh²

2007

Pacing Clinical Electrophis

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“…Eligible patients were randomly assigned to one of the two groups: Group A included 25 patients with RV apical pacing, and Group B included 25 patients with RV basal septal pacing. The atrial lead was positioned in the right atrial appendage in all the patients because of stability, and also it has been shown to have better left ventricular filling and cardiac output compared to stimulation from the right atrial free wall . The site of RV lead was either at the RV apex or the RV septum, as described previously (Figure ) …”

Section: Methodsmentioning

confidence: 99%

What are the atrioventricular delays in right ventricular apical and septal pacing for optimal hemodynamics in patients with normal left ventricular function?

Shenthar

George

Banavalikar

et al. 2019

Cardiovasc electrophysiol

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Introduction: There is a surge of interest in alternate site pacing to prevent pacinginduced left ventricular dysfunction. However, little is known regarding the appropriate atrioventricular (AV) delay between right ventricular (RV) septal and RV apical pacing for optimal hemodynamic benefit.Objectives: To determine the programmed values of atrial sensed and atrial paced AV delays in basal RV septal and apical RV pacing that results in the maximum delivered stroke volume (SV). Methods:We calculated the Doppler-derived SV at various sensed and paced AV delays in 50 patients with complete AV block implanted with a dual-chamber pacemaker (group A: 25 RV apical pacing; group B: 25 RV septal pacing). The hemodynamic difference in terms of the SV between sensed and paced AV delay, corresponding to the site of RV pacing was then compared for statistical significance.Results: In group A, maximal SV was derived at a sensed AV delay of 123.2 ± 11 ms and paced AV delay of 129.2 ± 10 ms, and in group B, at a sensed AV delay of 123.6 ± 8 ms and paced AV delay of and 132.8 ± 7 ms. At these intervals, there was no difference in the SV between septal and apical RV pacing (P = .28 and .22, respectively). Conclusion:The atrial sensed and atrial paced AV delays for septal and apical RV pacing for optimal hemodynamics are similar. For optimal hemodynamics, the atrial paced AV delay is longer than the atrial sensed AV delay. K E Y W O R D S optimal AV delay, paced AV delay, RV apical pacing, RV septal pacing, sensed AV delay 1 | INTRODUCTION Dual-chamber pacing is considered to be more physiological than singlechamber ventricular pacing. Dual-chamber pacemakers attempt to mimic normal atrioventricular (AV) synchrony by pacing the ventricles sequentially in response to atrial activity. The lack of hemodynamic benefit during single-chamber ventricular pacing (VVI) is due to loss of atrial contribution to the ventricular filling. Long-term VVI pacing is associated with biatrial dilatation and significant changes in atrial electrophysiology, such as nonuniform prolongation of atrial refractory periods, Abbreviations: AV, atrioventricular; LV, left ventricle; RV, right ventricle; SV, stroke volume; VTI, velocity time integral. Bharatraj Banavalikar http://orcid.org/0000-0003-1116-3967 Deepak Padmanabhan http://orcid.org/0000-0002-9127-9275 Mukund A. Prabhu http://orcid.org/0000-0001-9908-2891 How to cite this article: Shenthar J, George J, Banavalikar B, Padmanabhan D, Prabhu MA. What are the atrioventricular delays in right ventricular apical and septal pacing for optimal hemodynamics in patients with normal left ventricular function? J Cardiovasc Electrophysiol. 2020;31:323-329.

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“…All the patients were elective cases with predominantly preserved left ventricular function and without atrioventricular or intraventricular conduction anomalies. Exclusion criteria were (1) age less than 25 or greater than 75 years, (2) sinus rhythm, (3) tachycardia (>100 beats/min), (4) the presence of a permanent pacing system, and (5) the need for emergency operation or intraaortic balloon pumping, or both. Risk stratification was performed with the Euroscore.…”

Section: Methodsmentioning

confidence: 99%

Temporary Epicardial Ventricular Stimulation in Patients with Atrial Fibrillation: Acute Effects of Ventricular Pacing Site on Bypass Graft Flows

Madershahian¹,

Liakopoulos²,

Wittwer³

et al. 2009

Journal of Cardiac Surgery

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Differences in pacing from the atrial appendage and the lateral atrial free wall on left ventricular filling and haemodynamics during DDD pacing

Abstract: Stimulation from the RAA was superior to stimulation from the right atrial free wall with respect to left ventricular filling and cardiac output. Compared with stimulation from the right atrial free wall, RAA pacing resulted in an increase of 10-15% in cardiac output.

Cited by 9 publications

References 8 publications

Noncatheter‐Based Delivery of a Single‐Chamber Lumenless Pacing Lead in Small Children

Noncatheter‐Based Delivery of a Single‐Chamber Lumenless Pacing Lead in Small Children

What are the atrioventricular delays in right ventricular apical and septal pacing for optimal hemodynamics in patients with normal left ventricular function?

Temporary Epicardial Ventricular Stimulation in Patients with Atrial Fibrillation: Acute Effects of Ventricular Pacing Site on Bypass Graft Flows

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