Long-Term Effect of Right Ventricular Pacing on Myocardial Perfusion and Function

Tse, Hung‐Fat; Lau, Chu‐Pak

doi:10.1016/s0735-1097(96)00586-4

Cited by 407 publications

(275 citation statements)

References 23 publications

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“…[1][2][3][4][5][6][7] Our data support the previous observations and suggest that LV dyssynchrony plays a role in deteriorating ventricular function in RAP. Such negative consequences may be explained by the fact that RAP produces an electrical activation sequence similar to left bundle branch block.…”

Section: Discussionsupporting

confidence: 87%

“…18) Similar findings were observed in patients exposed to RAP even in the absence of coronary artery disease. 3) Shortening of LV filling time may also reduce coronary blood flow, predisposing to further impairment of ventricular function. During RAP, moreover, there may be asymmetric hypertrophy, which is most pronounced in the latest-activated region.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Left Ventricular Dyssynchrony on Plasma B-Type Natriuretic Peptide Levels in Patients With Long-Term Right Ventricular Apical Pacing

et al. 2008

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SUMMARYRight ventricular apical pacing (RAP) has been reported to have the potential to lead to left ventricular (LV) dyssynchrony and impaired LV function. The plasma level of Btype natriuretic peptide (BNP) is increased in the state of abnormal ventricular wall stretch. Therefore, the aim of the present study was to examine the effect of LV dyssynchrony on BNP levels in patients with chronic RAP.Thirty-four patients (17 women, age 69 ± 11 years) with preserved LV systolic function on permanent RAP (duration, 7.0 ± 4.7 years) underwent conventional echo-Doppler assessment and tissue Doppler imaging. Twenty-two normal subjects (8 women, age 66 ± 9 years) served as controls. The standard deviation (SD) and dispersion of the time-topeak systolic velocity (TPV) among the 6 basal LV segments were used as the indexes of LV dyssynchrony.Compared with control subjects, RAP patients had prolonged TPVs and heterogeneous LV contraction with greater values of TPV-SD (18 ± 8 ms versus 39 ± 15 ms, P < 0.001) and TPV-dispersion (42 ± 20 ms versus 93 ± 31 ms, P < 0.001). There were significant correlations between BNP levels and the indexes of LV dyssynchrony (r = 0.41, P = 0.017 for TPV-SD; r = 0.46, P = 0.006 for TPV-dispersion).RAP is associated with LV dyssynchrony, which may accelerate BNP secretion. (Int Heart J 2008; 49: 165-173) Key words: B-type natriuretic peptide (BNP), Tissue Doppler, Dyssynchrony, Echocardiography, Pacing RIGHT ventricular apical pacing (RAP) has been reported to have the potential to lead to left ventricular (LV) dysfunction even in the absence of structural heart disease. Underlying mechanisms of impaired LV function during RAP include alterations of cellular structure and ventricular geometry, systolic and diastolic dysfunction, mitral regurgitation, and increased left atrial diameters.1-5) Systolic dyssynchrony may also play a role in deteriorating LV pump function because From the

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Effect of Left Ventricular Dyssynchrony on Plasma B-Type Natriuretic Peptide Levels in Patients With Long-Term Right Ventricular Apical Pacing

et al. 2008

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“…This study extends our understanding of how different RV pacing sites influence cardiac performance. The RV apex is the traditional site for ventricular pacing due to technical aspects such as the electrode design and the ease of the apical approach [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Changes in left ventricular global and regional longitudinal strain during right ventricular pacing

Algazzar¹,

Katta²,

Ahmed³

et al. 2016

ica

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Background:Our study aimed to demonstrate the short-term impacts of right ventricular apical pacing (RVAP) and right ventricular septal pacing (RVSP) on left ventricular (LV) regional longitudinal strain (RLS) and global longitudinal strain (GLS) in patients with preserved ejection fraction (EF). LV strain and functions may be altered by RVAP. RVSP might be a better alternative. The detrimental effect of right ventricular (RV) pacing may be mediated by regional LV impairment.

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“…При проведении сцинти-графии миокарда обнаружено, что у 46-75% пациентов с ПЖ-стимуляцией выявляются дефекты перфузии, не свя-занные со стенозирующим поражением коронарных арте-рий [27,36]. Наиболее частая их локализация -нижняя стенка, верхушка, межжелудочковая перегородка.…”

Section: патогенез неблагоприятных последствий апикальной пж-стимуляцииunclassified

“…Другими возможными механизмами могут являться вазоконстрикция вследствие повышения тканевого нор-эпинефрина в зоне стимуляции [18,26] и поражение ми-кроциркуляторного русла за счет фиброзно-дегенератив-ных процессов [12]. Дефекты перфузии могут сочетаться с нарушениями локальной сократимости в соответствую-щих зонах, которые невозможно отличить от рубцового поражения миокарда вследствие перенесенного инфаркта [36]. Это представляет существенные трудности при диа-гностике ишемической болезни сердца (ИБС) у пациен-тов с постоянной ПЖ-стимуляцией.…”

Section: патогенез неблагоприятных последствий апикальной пж-стимуляцииunclassified

Importance of the heart failure mechanisms during permanent single-chamber cardiac pacing for optimization of rate-adaptive mode

Kuznetsova¹,

Андреев²,

Сыркин³

et al. 2015

Kardiol. serdechno-sosud. khir.

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При постоянной электрокардиостимуляции сердца риск сердечной недостаточности (СН) повышен. В настоящем обзоре освещены механизмы развития СН при однокамерной электрокардиостимуляции сердца и основные подходы к преодолению данной проблемы. Особое внимание уделено обсуждению возможностей оптимизации режима частотной адаптации для уменьшения СН. Ключевые слова: постоянная однокамерная электрокардиостимуляция сердца, апикальная правожелудочковая стимуля-ция, хронотропная некомпетентность, сердечная недостаточность, режим частотной адаптации.The risk of heart failure in increased in case of permanent cardiac pacing. Heart failure mechanisms during permanent singlechamber cardiac pacing and main approaches to overcome these problems are being discussed in the review. Possibilities to optimize rate-adaptive modes for heart failure reducing are emphasized.Keywords: permanent single-chamber cardiac pacing, apical right ventricular pacing, chronotropic incompetence, heart failure, rate-adaptive mode.

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Long-Term Effect of Right Ventricular Pacing on Myocardial Perfusion and Function

Abstract: Long-term right ventricular apical pacing resulted in a high incidence of myocardial perfusion defects that increased with the duration of pacing. These myocardial perfusion abnormalities were associated with apical wall motion abnormalities and impaired global left ventricular function.

Cited by 407 publications

References 23 publications

Effect of Left Ventricular Dyssynchrony on Plasma B-Type Natriuretic Peptide Levels in Patients With Long-Term Right Ventricular Apical Pacing

Effect of Left Ventricular Dyssynchrony on Plasma B-Type Natriuretic Peptide Levels in Patients With Long-Term Right Ventricular Apical Pacing

Changes in left ventricular global and regional longitudinal strain during right ventricular pacing

Importance of the heart failure mechanisms during permanent single-chamber cardiac pacing for optimization of rate-adaptive mode

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