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Dynamic and site-specific impact of ventricular pacing on left ventricular ejection fraction

Schwartzman, D and Johnson, L and Tanaka, H and Ota, T and Gorcsan, J and Lamia, B and Pinsky, MR and Shroff, SG (2010) Dynamic and site-specific impact of ventricular pacing on left ventricular ejection fraction. Heart Rhythm, 7 (6). 813 - 819. ISSN 1547-5271

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Background: Some studies suggest that right ventricular (RV) pacing has an adverse impact on left ventricular ejection fraction (LVEF), particularly in subjects with preexisting left ventricular (LV) dysfunction, and that direct LV pacing may be relatively protective. Interactions between pacing site and LVEF remain unclear. Objective: The purpose of this study was to examine the relative impact of RV and LV pacing on LVEF by serial study during a period in which LV dysfunction, induced by tachypacing, was introduced and then resolved. Methods: In each of five dogs, RV, LV, and simultaneous RV and LV (BiV) pacing modes were compared to native ventricular activation (1) prior to tachypacing (baseline), (2) weekly during a 5-week continuous tachypacing period, and (3) weekly during a 3-week post-tachypacing recovery period. At each evaluation, LVEF and LV contraction synchrony were assessed during each pacing mode. Results: The decrease in LVEF during the tachypacing period was more pronounced during RV pacing than during native activation or LV or BiV pacing. The magnitude of this effect correlated with a diminishment in LV contraction synchrony that was not observed during native activation or LV or BiV pacing. During the post-tachypacing period, gradual reversal of these changes toward baseline was observed. Conclusion: Compared to native activation, RV pacing worsens LVEF in a manner proportional to the severity of preexisting LV dysfunction, attributable to reduced LV contraction synchrony. In comparison, both LV and BiV pacing preserve LVEF and contraction synchrony. © 2010 Heart Rhythm Society.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Schwartzman, D
Johnson, L
Tanaka, H
Ota, T
Gorcsan, Jgorcsan@pitt.eduGORCSAN
Lamia, B
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Shroff, SGsshroff@pitt.eduSSHROFF
Date: 1 June 2010
Date Type: Publication
Journal or Publication Title: Heart Rhythm
Volume: 7
Number: 6
Page Range: 813 - 819
DOI or Unique Handle: 10.1016/j.hrthm.2010.02.034
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 1547-5271
PubMed ID: 20206298
Date Deposited: 07 Mar 2012 20:49
Last Modified: 30 Jan 2020 16:55


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