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Chinese Heart Journal. 2012, (01)

Impact on left ventricular systolic function by long-term permanent right ventricular pacing in different sitesChinese Full Text

SHI Xiang-min1,WANG Yu-tang1,SHAN Zhao-liang2,YANG Ting-shu1(1.Department of Cardiology,South Building,2.Department of Cardiology,PLA General Hospital,Beijing 100853,China)

Abstract: AIM:To compare the effects on left ventricular systolic function by long-term permanent pacing in right ventricular apex（RVA） and right ventricular outflow tract septal（RVOT-S） and to investigate the optimal right ventricular site for permanent pacing.METHODS:Thirty-six patients diagnosed as having complete atrial-ventricular block（CAVB） and normal left ventricular systolic function and who were hospitalized during the period of August 2007 to December 2009 [male/female=20/16,mean age:（51.3±22.2） years] were randomly assigned to RVA pacing group and RVOT-S pacing group.Twelve months after implantation of permanent pacemakers,left ventricular ejection fraction（LVEF）,left ventricular end-systolic volume（LVESV）,aortic velocity time integral（VTI）,activation delay between aortic and pulmonary artery valve（QAO-QP）,atrial fibrillation burden（AFb）,automatic mode switch（AMS）,serum NT-Pro-BNP（NT-proBNP） and width of QRS were analyzed and compared between groups.RESULTS:After 12 months pacing,LVEF and VTI in RVOT-S group were significant higher than those in RVA group（P＜0.05）.LVESV,QAO-QP,AFb,AMS,N-BNP and QRS width in RVOT-S group were statistically lower than those in RVA group（P＜0.05）.CONCLUSION:Long-term RVA pacing could induce inter-and intraventricular desynchrony and left ventricular remodeling,which would impair the left ventricular systolic function.RVOT-S could be the optimal site for permanent ventricular pacing.
Keywords：

pacing,right ventricular apex; right ventricular septal outflow tract; left ventricular systolic function;

  • DOI：

    10.13191/j.chj.2012.01.84.shixm.022

  • Series：

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  • Classification Code：

    R541.7

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