Medicinski pregled 2016 Volume 69, Issue 7-8, Pages: 212-216
https://doi.org/10.2298/MPNS1608212M
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The effect of right ventricular pacemaker lead position on functional status in patients with preserved left ventricular ejection fraction
Mitov Vladimir M. (Medical Center Zaječar, Department of Interventional Cardiology, Zaječar)
Perišić Zoran 
(University Hospital Niš, Department of Interventional Cardiology, Niš)
Jolić Aleksandar (Medical Center Zaječar, Department of Interventional Cardiology, Zaječar)
Kostić Tomislav (University Hospital Niš, Department of Interventional Cardiology, Niš)
Aleksić Aleksandar (Medical Center Zaječar, Department of Interventional Cardiology, Zaječar)
Aleksić Željka (Medical Center Zaječar, Department of Nuclear Medicine, Zaječar)
Introduction. The study was aimed at assessing the difference between the
right ventricle apex versus the right ventricular outflow tract lead position
in functional capacity in the patients with the preserved left ventricular
ejection fraction after 12 months of pacemaker stimulation. Material and
Methods. This was a prospective, randomized, follow-up study, which lasted
for 12 months. The study sample included 132 consecutive patients who were
implanted with permanent anti-bradicardiac pacemaker. Regarding the right
ventricular lead position the patients were divided into two groups: the
right ventricle apex group consisting of 61 patients with right ventricular
apex lead position. The right ventricular outflow tract group included 71
patients with right ventricular outflow tract lead position. Functional
capacity was assessed by Minnesota Living With Heart Failure score, New York
Heart Association class and Six Minute Walk Test. Left ventricular ejection
fraction was assessed by echocardiography. Results. Minnesota Living With
Heart Failure score and New York Heart Association class had a statistically
significant improvement in both study groups. The patients from right
ventricle apex group walked 20.95% (p=0.03) more in comparison to starting
values. The patients from right ventricular outflow tract group walked only
13.63% (p=0.09) longer distance than the starting one. Conclusion. Analysis
of tests of functional status New York Heart Association class and Minnesota
Living With Heart Failure questionnaire showed an even improvement in the
right ventricle apex and right ventricular outflow tract groups. Analysis of
6 minute walk test showed that only the patients with the preserved left
ventricular ejection fraction from the right ventricle apex group had a
significant improvement after 12 months of pacemaker stimulation.
Keywords: Pacemaker, Artificial, Electrodes, Implanted, Heart Ventricles, Ventricular Function, Left, Stroke Volume, Questionnaires, Walking, Bradycardia, Treatment Outcome