Outcome of Right Ventricular Bifocal Pacing in Patients with Permanent Atrial Fibrillation and Severe Dilated Cardiomiopathy Due to Chagas Disease: Three Years of Follow-up

Menezes, Antônio da Silva

doi:10.1023/b:jice.0000048569.71590.c5

Cited by 18 publications

(9 citation statements)

References 13 publications

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“…Echocardiography is used in the routine clinical evaluation of CCM patients to assess disease progression, in survival studies 31,32,34,38,[57][58][59][60] to rule out the presence of intraventricular thrombus, 29,34 in the follow-up of pacemakers devices 61 and implanted automatic cardioverter-defibrillators, 62 and to monitor response to vasodilator therapy in patients with HF (enalapril) 63 or to antiparasitic medications (benznidazole), 64 among others. The last study showed in a long-term follow-up that the only independent predictors of deteriorating clinical status were a lower echocardiographic LVEF and a higher LV end-diastolic diameter.…”

Section: Applications In the Management Of Patientsmentioning

confidence: 99%

Echocardiography in Chagas Heart Disease

2007

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Background-Chagas heart disease is a frequent cause of morbidity and mortality in Latin America. Echocardiography provides useful diagnostic and prognostic information and is an important tool in the management of patients with Chagas disease. Methods and Results-A search for relevant publications was obtained from MEDLINE, LILACS, and SCIELO sources.Acute Chagas myocarditis is a rare disorder in which pericardial effusion is frequent. Echocardiography may exclude pericardial tamponade in case of heart failure. Chronic Chagas cardiomyopathy evolves for several decades after the infection. Epidemiological history, positive serology, and suggestive clinical and ECG abnormalities establish the diagnosis. About three quarters of chronic Chagas cardiomyopathy subjects remain asymptomatic with normal (indeterminate form) or abnormal ECGs. Early Doppler abnormalities includes prolongation of isovolumic contraction and relaxation times. Systolic function frequently is normal, but dysfunction may be elicited by stress tests. Half or more of symptomatic patients have a left ventricular apical aneurysm and other segmental contractile abnormalities similar to those seen in coronary heart disease. The dilated nonsegmental form is indistinguishable from dilated cardiomyopathy. Results from univariate and multivariate Cox survival analyses indicate that impaired systolic function and increased ventricular dimensions have significant value in predicting cardiac morbidity and mortality. Cardiac ultrasound commonly is used in the follow-up of patients and in the assessment of various therapeutic modalities. Conclusions-Echocardiographic and Doppler techniques provide useful structural and functional information in the detection of early myocardial damage, risk assessment of prognosis, disease progression, and management of patients with Chagas disease.

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Section: Applications In the Management Of Patientsmentioning

confidence: 99%

Echocardiography in Chagas Heart Disease

2007

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“…Pacing at virtually any ventricular site changes the natural pattern of activation and contraction sequence because the electrical wave front takes place more slowly through ventricular myocardium than through the His‐Purkinje system. Experimental and clinical studies have evaluated alternative ventricular pacing sites, like RV outflow tract (RVOT), mid‐septum (MS), His bundle, dual‐site RV, LV, and biventricular (BIV) 7–12 . The efficacy and benefit of alternative RV pacing sites are still controversial because previous studies evaluated acute and not chronic effects and were limited by evaluation of only a few patients with low ejection fraction (LEF) 13 .…”

Section: Introductionmentioning

confidence: 99%

Effect of Pacing the Right Ventricular Mid‐Septum Tract in Patients with Permanent Atrial Fibrillation and Low Ejection Fraction

Muto¹,

Ottaviano²,

Canciello³

et al. 2007

Cardiovasc electrophysiol

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“…Several non-randomised long-term studies in CRT candidates, including single case reports, suggest that bifocal RV pacing may yield a sustained haemodynamic benefit with improvement in LV function 15 16. O’Donnell et al implanted a bifocal RV lead system when lateral LV pacing could not be achieved in 50 consecutive CRT candidates who were followed up for 12 months 15.…”

Section: Monochamber LV Pacingmentioning

confidence: 99%