Long-term effect of right ventricular pacing on myocardial perfusion and function
HF Tse
and
CP Lau
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
OBJECTIVES: The purpose of this study was to investigate the effect of long-term ventricular pacing on myocardial perfusion and function in patients receiving such pacing. BACKGROUND: The long-term effect of ventricular pacing on myocardial perfusion and function in humans is unclear, although animal studies have suggested that it may be adverse. METHODS: Forty-three patients with complete heart block and dual-chamber rate-adaptive (DDDR) pacing were studied. All underwent thallium-201 (Tl-201) exercise myocardial scintigraphy to assess myocardial perfusion and radionuclide ventriculography to determine left ventricular function and regional wall motion. Coronary angiography was also performed in patients with abnormal findings on Tl-201 study. RESULTS: There was no significant difference in mean age, gender, percent ventricular pacing, pacing threshold, ventricular pacing output and metabolic equivalents on exercise testing between patients with or without perfusion defects on exercise Tl-201 scintigraphy. However, the duration of pacing tended to be longer in patients with than in those without perfusion defects (43.9 +/- 49.7 vs. 20.1 +/- 9.8 months, p = 0.05). Tl-201 perfusion defects were noted in 28 (65%) of 43 of patients (inferior 78% [n = 22], apical 67% [n = 17], septal 21% [n = 6], anterior 7% [n = 2], lateral 3% [n = 1)]. Of 16 of 28 patients with abnormal Tl-201 findings who underwent coronary angiography, only 3 (19%) had significant coronary artery disease. Patients with an abnormal perfusion defect had a significantly lower left ventricular ejection fraction (48.5 +/- 9.9% vs. 59.6 +/- 8.9%, p < 0.001) and a higher percent of wall motion abnormalities (57% vs. 20%, p = 0.026), mainly over apical regions. CONCLUSIONS: 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.
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(2009)
jep171v1.
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[Full Text]
[PDF]
|
 |
|

|
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November 1, 2009;
11(11):
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|
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|

|
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|
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54(9):
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[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Jacob, A. Kondur, V. Khetarpal, and L. Afonso
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Circ Arrhythm Electrophysiol,
August 1, 2009;
2(4):
e21 - e23.
[Full Text]
[PDF]
|
 |
|

|
 |

|
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H.-F. Tse, K.-K. Wong, C.-W. Siu, M.-O. Tang, V. Tsang, W.-Y. Ho, and C.-P. Lau
Impacts of ventricular rate regularization pacing at right ventricular apical vs. septal sites on left ventricular function and exercise capacity in patients with permanent atrial fibrillation
Europace,
May 1, 2009;
11(5):
594 - 600.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. W.X. Foley, S. A. Muhyaldeen, S. Chalil, R. E.A. Smith, J. E. Sanderson, and F. Leyva
Long-term effects of upgrading from right ventricular pacing to cardiac resynchronization therapy in patients with heart failure
Europace,
April 1, 2009;
11(4):
495 - 501.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. J. Camm, P. Kirchhof, G. Y.H. Lip, I. Savelieva, and S. Ernst
CHAPTER 29 Atrial Fibrillation
ESC Textbook of Cardiovascular Medicine,
January 1, 2009;
2(1):
med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. Nagele, W. Rodiger, and M. A. Castel
Rate-responsive pacing in patients with heart failure: long-term results of a randomized study
Europace,
October 1, 2008;
10(10):
1182 - 1188.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. O. Sweeney and F. W. Prinzen
Ventricular Pump Function and Pacing: Physiological and Clinical Integration
Circ Arrhythm Electrophysiol,
June 1, 2008;
1(2):
127 - 139.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Almendral, F. Arribas, C. Wolpert, R. Ricci, P. Adragao, E. Cobo, X. Navarro, A. Quesada, and the DATAS Steering Committee and Writing Committee
Dual-chamber defibrillators reduce clinically significant adverse events compared with single-chamber devices: results from the DATAS (Dual chamber and Atrial Tachyarrhythmias Adverse events Study) trial
Europace,
May 1, 2008;
10(5):
528 - 535.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
F. Zanon, E. Bacchiega, L. Rampin, S. Aggio, E. Baracca, G. Pastore, T. Marotta, G. Corbucci, L. Roncon, D. Rubello, et al.
Direct His bundle pacing preserves coronary perfusion compared with right ventricular apical pacing: a prospective, cross-over mid-term study
Europace,
May 1, 2008;
10(5):
580 - 587.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
O. C. Perez, M. J. Sancho-Tello de Carranza, J. O. Asensi, and J. A. Olague de Ros
Pacemaker malfunction or non-physiological ventricular pacing?
Europace,
February 1, 2008;
10(2):
161 - 163.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R E Lane, J Mayet, N S Peters, D W Davies, and A W C Chow
Comparison of temporary bifocal right ventricular pacing and biventricular pacing for heart failure: evaluation by tissue Doppler imaging
Heart,
January 1, 2008;
94(1):
53 - 58.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. Vatasescu, T. Shalganov, D. Paprika, L. Kornyei, Z. Prodan, G. Bodor, A. Szatmari, and T. Szili-Torok
Evolution of left ventricular function in paediatric patients with permanent right ventricular pacing for isolated congenital heart block: a medium term follow-up
Europace,
April 1, 2007;
9(4):
228 - 232.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H.-F. Tse and C.-P. Lau
Selection of Permanent Ventricular Pacing Site: How Far Should We Go?
J. Am. Coll. Cardiol.,
October 17, 2006;
48(8):
1649 - 1651.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. F. Tops, M. J. Schalij, E. R. Holman, L. van Erven, E. E. van der Wall, and J. J. Bax
Right Ventricular Pacing Can Induce Ventricular Dyssynchrony in Patients With Atrial Fibrillation After Atrioventricular Node Ablation
J. Am. Coll. Cardiol.,
October 17, 2006;
48(8):
1642 - 1648.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. Lieberman, L. Padeletti, J. Schreuder, K. Jackson, A. Michelucci, A. Colella, W. Eastman, S. Valsecchi, and D. A. Hettrick
Ventricular Pacing Lead Location Alters Systemic Hemodynamics and Left Ventricular Function in Patients With and Without Reduced Ejection Fraction
J. Am. Coll. Cardiol.,
October 17, 2006;
48(8):
1634 - 1641.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. Rubaj, P. Rucinski, K. Rejdak, K. Oleszczak, D. Duma, P. Grieb, and A. Kutarski
Biventricular versus right ventricular pacing decreases immune activation and augments nitric oxide production in patients with chronic heart failure
Eur J Heart Fail,
October 1, 2006;
8(6):
615 - 620.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. C. Funck, J.-J. Blanc, H.-H. Mueller, C. Schade-Brittinger, C. Bailleul, B. Maisch, and for the BioPace Study Group
Biventricular stimulation to prevent cardiac desynchronization: rationale, design, and endpoints of the 'Biventricular Pacing for Atrioventricular Block to Prevent Cardiac Desynchronization (BioPace)' study.
Europace,
August 1, 2006;
8(8):
629 - 635.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. O. Sweeney and F. W. Prinzen
A New Paradigm for Physiologic Ventricular Pacing
J. Am. Coll. Cardiol.,
January 17, 2006;
47(2):
282 - 288.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Dilaveris, A. Pantazis, G. Giannopoulos, A. Synetos, J. Gialafos, and C. Stefanadis
Upgrade to biventricular pacing in patients with pacing-induced heart failure: can resynchronization do the trick?
Europace,
January 1, 2006;
8(5):
352 - 357.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Y. Zhang, H. Yamada, S. Bibevski, S. Zhuang, K. A. Mowrey, D. W. Wallick, S. Oh, and T. N. Mazgalev
Chronic Atrioventricular Nodal Vagal Stimulation: First Evidence for Long-Term Ventricular Rate Control in Canine Atrial Fibrillation Model
Circulation,
November 8, 2005;
112(19):
2904 - 2911.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. Szili-Torok, M. Bountioukos, A. J.Q.M. Muskens, D. A.M.J. Theuns, D. Poldermans, J. R.T.C. Roelandt, and L. J. Jordaens
The presence of contractile reserve has no predictive value for the evolution of left ventricular function following atrio-ventricular node ablation in patients with permanent atrial fibrillation
Eur J Echocardiogr,
October 1, 2005;
6(5):
344 - 350.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. Preumont, J.-L. Jansens, G. Berkenboom, P. van de Borne, E. Stoupel, and S. Goldman
Effects of right ventricular pacing on regional myocardial glucose metabolism
Europace,
January 1, 2005;
7(6):
584 - 591.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Nahlawi, M. Waligora, S. M. Spies, R. O. Bonow, A. H. Kadish, and J. J. Goldberger
Left ventricular function during and after right ventricular pacing
J. Am. Coll. Cardiol.,
November 2, 2004;
44(9):
1883 - 1888.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Peschar, K. Vernooy, R. N Cornelussen, X. A.A.M Verbeek, R. S Reneman, M. A Vos, and F. W Prinzen
Structural, electrical and mechanical remodeling of the canine heart in AV-block and LBBB
Eur. Heart J. Suppl.,
August 1, 2004;
6(suppl_D):
D61 - D65.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L Kristensen, J C Nielsen, P T Mortensen, O L Pedersen, A K Pedersen, and H R Andersen
Incidence of atrial fibrillation and thromboembolism in a randomised trial of atrial versus dual chamber pacing in 177 patients with sick sinus syndrome
Heart,
June 1, 2004;
90(6):
661 - 666.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. A. Lamas, K. A. Ellenbogen, and With the Assistance of Charles H. Hennekens, MD, D
Evidence Base for Pacemaker Mode Selection: From Physiology to Randomized Trials
Circulation,
February 3, 2004;
109(4):
443 - 451.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. R.J. Mitchell and N. Sulke
How do atrial pacing algorithms prevent atrial arrhythmias?
Europace,
January 1, 2004;
6(4):
351 - 362.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
V.ér. Valls-Bertault, M. Fatemi, M. Gilard, P. Y. Pennec, Y. Etienne, and J.-J. Blanc
Assessment of upgrading to biventricular pacing in patients with right ventricular pacing and congestive heart failure after atrioventricular junctional ablation for chronic atrial fibrillation
Europace,
January 1, 2004;
6(5):
438 - 443.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. Masumoto, Y. Ueda, R. Kato, A. Usui, T. Maseki, Y. Takagi, and M. Usui
Long-term clinical performance of AAI pacing in patients with sick sinus syndrome: a comparison with dual-chamber pacing
Europace,
January 1, 2004;
6(5):
444 - 450.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. Ferro, C. Duilio, M. Santomauro, and A. Cuocolo
Walk test at increased levels of heart rate in patients with dual-chamber pacemaker and with normal or depressed left ventricular function
Eur. Heart J.,
December 1, 2003;
24(23):
2123 - 2132.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. S. Barold
Adverse effects of ventricular desynchronization induced by long-term right ventricular pacing
J. Am. Coll. Cardiol.,
August 20, 2003;
42(4):
624 - 626.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. N. Simantirakis, G. E. Kochiadakis, K. E. Vardakis, N. E. Igoumenidis, S. I. Chrysostomakis, and P. E. Vardas
Left Ventricular Mechanics and Myocardial Blood Flow Following Restoration of Normal Activation Sequence in Paced Patients With Long-term Right Ventricular Apical Stimulation
Chest,
July 1, 2003;
124(1):
233 - 241.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. I. Skalidis, P. E. Vardas, H. Ukkonen, R. S.B. Beanlands, I. Burwash, R. A. de Kemp, A. S.L. Tang, C. Nahmias, E. Fallen, and M. R.S. Hill
Cardiac Resynchronization and Myocardial Oxidative Metabolism * Response
Circulation,
June 24, 2003;
107
(24):
e220 - e220.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Prof. P. E. Vardas and E. I. Skalidis
Specificity of noninvasive pacemaker stress echocardiography in diagnosis of coronary artery disease
J. Am. Coll. Cardiol.,
March 19, 2003;
41(6):
1068 - 1069.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. C. Nielsen, M. Bottcher, H. K. Jensen, T. T. Nielsen, A. K. Pedersen, and P. T. Mortensen
Regional myocardial perfusion during chronic biventricular pacing and after acute change of the pacing mode in patients with congestive heart failure and bundle branch block treated with an atrioventricular sequential biventricular pacemaker
Eur J Heart Fail,
March 1, 2003;
5(2):
179 - 186.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H.-F. Tse, C. Yu, K.-K. Wong, V. Tsang, Y.-L. Leung, W.-Y. Ho, and C.-P. Lau
Functional abnormalities in patients with permanent right ventricular pacing: The effect of sites of electrical stimulation
J. Am. Coll. Cardiol.,
October 16, 2002;
40(8):
1451 - 1458.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. Picano, A. Alaimo, V. Chubuchny, E. Plonska, V. Baldo, U. Baldini, M. Pauletti, R. Perticucci, L. Fonseca, H. R. Villarraga, et al.
Noninvasive pacemaker stress echocardiography for diagnosis of coronary artery disease: A multicenter study
J. Am. Coll. Cardiol.,
October 2, 2002;
40(7):
1305 - 1310.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Zhuang, Y. Zhang, K. A. Mowrey, J. Li, T. Tabata, D. W. Wallick, Z. B. Popovic, R. A. Grimm, A. Natale, and T. N. Mazgalev
Ventricular Rate Control by Selective Vagal Stimulation Is Superior to Rhythm Regularization by Atrioventricular Nodal Ablation and Pacing During Atrial Fibrillation
Circulation,
October 1, 2002;
106(14):
1853 - 1858.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M E Marketou, E N Simantirakis, V K Prassopoulos, S I Chrysostomakis, A A Velidaki, N S Karkavitsas, and P E Vardas
Assessment of myocardial adrenergic innervation in patients with sick sinus syndrome: effect of asynchronous ventricular activation from ventricular apical stimulation
Heart,
September 1, 2002;
88(3):
255 - 259.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. F.M van Oosterhout, T. Arts, J. B Bassingthwaighte, R. S Reneman, and F. W Prinzen
Relation between local myocardial growth and blood flow during chronic ventricular pacing
Cardiovasc Res,
March 1, 2002;
53(4):
831 - 840.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. Szili-Torok, G. P. Kimman, D. Theuns, D. Poldermans, J. R. T. C. Roelandt, and L. J. Jordaens
Deterioration of left ventricular function following atrio-ventricular node ablation and right ventricular apical pacing in patients with permanent atrial fibrillation
Europace,
January 1, 2002;
4(1):
61 - 65.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E.N. Simantirakis, S.I. Chrysostomakis, M.E. Marketou, G.E. Kochiadakis, K.E. Vardakis, H.E. Mavrakis, and P. Vardas
Atrial and ventricular refractoriness in paced patients; circadian variation and its relationship to autonomic nervous system activity
Eur. Heart J.,
December 1, 2001;
22(23):
2192 - 2200.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
M. V. T. Tantengco, R. L. Thomas, and P. P. Karpawich
Left ventricular dysfunction after long-term right ventricular apical pacing in the young
J. Am. Coll. Cardiol.,
June 15, 2001;
37(8):
2093 - 2100.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E.N Simantirakis, V.K Prassopoulos, S.I Chrysostomakis, G.E Kochiadakis, S.I Koukouraki, J.P Lekakis, N.S Karkavitsas, and P.E Vardas
Effects of asynchronous ventricular activation on myocardial adrenergic innervation in patients with permanent dual-chamber pacemakers. An I123-metaiodobenzylguanidine cardiac scintigraphic study
Eur. Heart J.,
February 2, 2001;
22(4):
323 - 332.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
T Levy, S Walker, M Mason, P Spurrell, S Rex, S Brant, and V Paul
Importance of rate control or rate regulation for improving exercise capacity and quality of life in patients with permanent atrial fibrillation and normal left ventricular function: a randomised controlled study
Heart,
February 1, 2001;
85(2):
171 - 178.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
F Duru, R Luechinger, M.B Scheidegger, T.F Luscher, P Boesiger, and R Candinas
Pacing in magnetic resonance imaging environment: Clinical and technical considerations on compatibility
Eur. Heart J.,
January 2, 2001;
22(2):
113 - 124.
[PDF]
|
 |
|

|
 |

|
 |
 
E. I. Skalidis, G. E. Kochiadakis, S. I. Koukouraki, S. I. Chrysostomakis, N. E. Igoumenidis, N. S. Karkavitsas, and P. E. Vardas
Myocardial perfusion in patients with permanent ventricular pacing and normal coronary arteries
J. Am. Coll. Cardiol.,
January 1, 2001;
37(1):
124 - 129.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. C. Nielsen, M. Bottcher, T. Toftegaard Nielsen, A. K. Pedersen, and H. R. Andersen
Regional myocardial blood flow in patients with sick sinus syndrome randomized to long-term single chamber atrial or dual chamber pacing--effect of pacing mode and rate
J. Am. Coll. Cardiol.,
May 1, 2000;
35(6):
1453 - 1461.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Deshmukh, D. A. Casavant, M. Romanyshyn, and K. Anderson
Permanent, Direct His-Bundle Pacing : A Novel Approach to Cardiac Pacing in Patients With Normal His-Purkinje Activation
Circulation,
February 29, 2000;
101(8):
869 - 877.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Z.I. Harris and M.D. Gammage
Alternative right ventricular pacing sites -- where are we going?
Europace,
January 1, 2000;
2(2):
93 - 98.
[PDF]
|
 |
|

|
 |

|
 |
 
F. W. Prinzen, W. C. Hunter, B. T. Wyman, and E. R. McVeigh
Mapping of regional myocardial strain and work during ventricular pacing: experimental study using magnetic resonance imaging tagging
J. Am. Coll. Cardiol.,
May 1, 1999;
33(6):
1735 - 1742.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T LEVY, S WALKER, and V PAUL
AV node ablation and implantation of mode switching dual chamber pacemakers: effective treatment for drug refractory PAF
Heart,
April 1, 1999;
81(4):
450a - 451.
[Full Text]
|
 |
|

|
 |

|
 |
 
B. Schwaab, G. Frohlig, C. Alexander, M. Kindermann, N. Hellwig, H. Schwerdt, C.-M. Kirsch, and H. Schieffer
Influence of right ventricular stimulation site on left ventricular function in atrial synchronous ventricular pacing
J. Am. Coll. Cardiol.,
February 1, 1999;
33(2):
317 - 323.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J.C. Nielsen, A.K. Pedersen, P.T. Mortensen, and H.R. Andersen
Programming a fixed long atrioventricular delay is not effective in preventing ventricular pacing in patients with sick sinus syndrome
Europace,
January 1, 1999;
1(2):
113 - 120.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
C. C. de Cock, L. M. C. van Campen, O. Kamp, and C. A. Visser
Pacing-induced left ventricular dysfunction: Relationship with coronary perfusion
Europace,
January 1, 1999;
1(2):
146 - 147.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
H. R. Andersen, J. C. Nielsen, P. E. B. Thomsen, L. Thuesen, T. Vesterlund, A. K. Pedersen, and P. T. Mortensen
Atrioventricular Conduction During Long-Term Follow-Up of Patients With Sick Sinus Syndrome
Circulation,
September 29, 1998;
98(13):
1315 - 1321.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. C. Nielsen, H. R. Andersen, P. E. B. Thomsen, L. Thuesen, P. T. Mortensen, T. Vesterlund, and A. K. Pedersen
Heart Failure and Echocardiographic Changes During Long-term Follow-up of Patients With Sick Sinus Syndrome Randomized to Single-Chamber Atrial or Ventricular Pacing
Circulation,
March 17, 1998;
97(10):
987 - 995.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|