Hemodynamic comparison of endocardial pacing of outflow and inflow tracts of the right ventricle

Barold, S. Serge; Linhart, Joseph W.; Hildner, Frank J.; Samet, Philip

doi:10.1016/0002-9149(69)90032-0

Cited by 36 publications

(11 citation statements)

References 14 publications

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“…Several trials showed no difference (or statistically insignificant difference) in acute cardiac haemodynamic variables (cardiac output, EF) between RVA pacing and RVOT pacing 16 35 36 37 38 39. Meanwhile a few randomised trials revealed better acute LV haemodynamics with RVOT pacing 40 41 42 43.…”

Section: Selective Site Pacing Trialsmentioning

confidence: 99%

Selective site right ventricular pacing

Albouaini

Alkarmi

Mudawi

et al. 2009

Heart

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The right ventricular apex (RVA) has been the elective site for placing endocardial pacing leads since 1959 when Furman described the use of the transvenous route for pacemaker implantation. This site was used because it is easily accessible, readily identified and associated with a stable position and reliable chronic pacing parameters. It was recognised, however, that pacing from the RVA did not reproduce normal ventricular conduction or contraction. With the advent of reliable active fixation leads, alternative right ventricular sites became accessible and began to be explored. In this review, the detrimental effects of RVA pacing are outlined, the right ventricular outflow tract is defined and the evidence for selective site pacing is discussed.

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Section: Selective Site Pacing Trialsmentioning

confidence: 99%

Selective site right ventricular pacing

Albouaini

Alkarmi

Mudawi

et al. 2009

Heart

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“…Two studies from the 1960s examining the acute haemodynamic effects of pacing from several different sites produced disappointing results [28,29], which led to a prolonged hiatus in further work. Recently, however, interest in alternative or selective pacing sites has rekindled.…”

Section: Alternative Sites For Right Ventricular Pacingmentioning

confidence: 99%

“…They excluded those which did not have apical pacing for comparison [28,29,52], those utilizing epicardial rather than endocardial leads [38,47,53] and studies performed in heart failure patients [39,45,48], leaving only nine studies eligible for inclusion [33,34,36,37,40,44,46,49,50]. Analysis of the pooled data demonstrated a modest effect on cardiac haemodynamics in favour of RVOT pacing (odds ratio 0.34, CI 0.15-0.53) with only three of these studies being individually positive [44,49,50] and, in two, the initial pacing site was not randomized [49,50].…”

Section: Acute Hemodynamic Right Ventricular Outflow Tract Pacing Stumentioning

confidence: 99%

Selective site ventricular pacing

McGavigan

Mond

2006

Current Opinion in Cardiology

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“…The search for alternative ventricular pacing sites started early in the sixties when hemodynamics were tested acutely while pacing the right ventricle from different sites within the inflow and outflow tract 1,2 . Results were disappointing, and discouraged further studies for almost 20 years.…”

Section: Systolic Parametersmentioning

confidence: 99%

“…They included studies on pacing for conventional antibradycardia indications which had to be prospective and should have reported measurements of systolic left ventricular function. From 17 studies identified 3 were excluded for having used epicardial leads, 4–6 2 for comparisons of outflow tract pacing with the stimulation of various nonapical pacing sites, 1,2 1 for including only subjects with impaired left ventricular function, 7 and 2 for being restricted to patients with heart failure in association with bradyarrhythmia 8,9 . Eventually, the analysis included 9 reports on overall 227 patients, of whom 77 percent were male and 46 percent had ischemic heart disease.…”

Section: Systolic Parametersmentioning

confidence: 99%

Selective Site Pacing:

Fröhlig¹,

Schwaab²,

Kindermann³

2004

Pacing Clinical Electrophis

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Animal data and recent findings in humans have questioned the appropriateness of pacing the heart from the right ventricular apex. Numerous, mostly small sized, studies have evaluated alternative sites within the right ventricle. There is now sufficient evidence that right ventricular apical pacing in patients with left ventricular dysfunction with or without heart failure is detrimental. Pacing from the right side of the heart as an attempt at nonpharmacological therapy for heart failure, turns out to be obsolete. In antibradycardia pacing with the need for continuous ventricular support, the interest in preserving left ventricular function drives the ongoing search for the most favorable pacing site within the right ventricle. Results, so far, are conflicting which may be attributed to the inhomogeneity of patient groups, the small cohorts studied, the differing protocols used, and the lack of accepted definitions of right ventricular lead positions. Larger studies are needed to evaluate intraoperative criteria for optimal lead placement and the potential benefit of nonapical right ventricular pacing.

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Hemodynamic comparison of endocardial pacing of outflow and inflow tracts of the right ventricle

Cited by 36 publications

References 14 publications

Selective site right ventricular pacing

Selective site right ventricular pacing

Selective site ventricular pacing

Selective Site Pacing:

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