|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2000; 35:1453-1461 © 2000 by the American College of Cardiology Foundation |
a Department of Cardiology B, Skejby Sygehus, Aarhus University Hospital, Brendstrupgaardsvej, 8200-DK, Aarhus N, Denmark
Manuscript received September 7, 1999; revised manuscript received December 3, 1999, accepted January 17, 2000.
Reprint requests and correspondence: Dr. Henning Rud Andersen, Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, Brendstrupgaardsvej, 8200-DK, Aarhus N, Denmark
skejhra{at}aau.dk
OBJECTIVES
This study aimed to evaluate regional myocardial blood flow (MBF) and global left ventricular ejection fraction (LVEF) during chronic pacing in patients with sick sinus syndrome (SSS) randomized to either single chamber atrial (AAI) or dual chamber (DDD) pacing.
BACKGROUND
Experimental studies indicate that chronic pacing in the right ventricular apex changes regional MBF, thereby compromising left ventricular function.
METHODS
Thirty patients (age 74 ± 10 years) were randomized to AAI (n = 15) or DDD (n = 15) pacemakers. After 22 ± 7 months of pacing, MBF was quantified with 13N-labeled ammonia positron emission tomography scanning at 60 beats per min and 90 beats per min. Patients in the DDD group furthermore underwent MBF measurement at temporary AAI pacing, 60 beats per min. Myocardial blood flow was assessed in the anterior, lateral, inferior and septal regions, and the global mean MBF was calculated. Left ventricular ejection fraction was determined by echocardiography at pacemaker implantation and at the time of MBF measurements.
RESULTS
Myocardial blood flow at rates 60 and 90 beats per min did not differ between the AAI and DDD groups. During temporary AAI pacing in the DDD group, MBF was significantly higher than during DDD pacing in both the inferior (p = 0.001) and septal (p = 0.004) regions and also globally (0.61 ± 0.15 vs. 0.53 ± 0.13 mL·g–1·min–1, p = 0.005). In the DDD group, LVEF decreased from pacemaker implantation to time of MBF measurements (0.61 ± 0.09 vs. 0.56 ± 0.07, p = 0.013). Left ventricular ejection fraction during temporary AAI pacing at time of MBF measurements was not different from LVEF at pacemaker implantation.
CONCLUSIONS
In patients with SSS, chronic DDD pacing reduced inferior, septal and global mean MBF as well as LVEF, as compared with temporary AAI pacing. The LVEF reversed to baseline level during temporary AAI pacing despite 22 months of permanent ventricular pacing preceding it. Augmenting pace rate to 90 beats per min increased MBF equally in the two treatment groups.
| ||||||||||||||||||||||||||||||||||||
This article has been cited by other articles:
|
|
 |
|
  M. O. Sweeney and F. W. Prinzen Ventricular Pump Function and Pacing: Physiological and Clinical Integration Circ Arrhythmia Electrophysiol, June 1, 2008; 1(2): 127 - 139. [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]
|
|
|
|
 |
|
 N. C. Wang, R. Passman, J. J. Goldberger, M. O. Sweeney, and G. A. Lamas Minimizing Ventricular Pacing in Sinus-Node Disease N. Engl. J. Med., December 27, 2007; 357(26): 2733 - 2734. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Occhetta, M. Bortnik, A. Magnani, G. Francalacci, C. Piccinino, L. Plebani, and P. Marino Prevention of Ventricular Desynchronization by Permanent Para-Hisian Pacing After Atrioventricular Node Ablation in Chronic Atrial Fibrillation: A Crossover, Blinded, Randomized Study Versus Apical Right Ventricular Pacing J. Am. Coll. Cardiol., May 16, 2006; 47(10): 1938 - 1945. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. D.R. Thackray, K. Witte, J. Ghosh, N. Nikitin, A. Anderson, A. Rigby, K. Goode, A. L. Clark, and J. G.F. Cleland N-terminal brain natriuretic peptide as a screening tool for heart failure in the pacemaker population Eur. Heart J., February 2, 2006; 27(4): 447 - 453. [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]
|
|
|
|
|
|
R. Anzawa, S. Ishikawa, Y. Tanaka, F. Okazaki, and S. Mochizuki Increased AAI mode pacing threshold after termination of atrial fibrillation by acute administration of disopyramide phosphate. Europace, January 1, 2006; 8(5): 345 - 348. [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]
|
|
|
|
 |
|
 M E Marketou, E N Simantirakis, D Nikitovic, S I Chrysostomakis, E A Zacharis, and P E Vardas Impact of asynchronous ventricular activation on pro-inflammatory cytokines and oxidative stress in paced patients Heart, June 1, 2005; 91(6): 817 - 818. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Wonisch, P. Lercher, D. Scherr, R. Maier, R. Pokan, P. Hofmann, and S. P. von Duvillard Influence of Permanent Right Ventricular Pacing on Cardiorespiratory Exercise Parameters in Chronic Heart Failure Patients With Implanted Cardioverter Defibrillators Chest, March 1, 2005; 127(3): 787 - 793. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Rinfret, D. J. Cohen, G. A. Lamas, K. E. Fleischmann, M. C. Weinstein, J. Orav, E. Schron, K. L. Lee, and L. Goldman Cost-Effectiveness of Dual-Chamber Pacing Compared With Ventricular Pacing for Sinus Node Dysfunction Circulation, January 18, 2005; 111(2): 165 - 172. [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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
M. O. Sweeney, A. S. Hellkamp, K. A. Ellenbogen, A. J. Greenspon, R. A. Freedman, K. L. Lee, and G. A. Lamas Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation Among Patients With Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction Circulation, June 17, 2003; 107(23): 2932 - 2937. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D.R. Thackray, K. K.A. Witte, N. P. Nikitin, A. L. Clark, G. C. Kaye, and J. G.F. Cleland The prevalence of heart failure and asymptomatic left ventricular systolic dysfunction in a typical regional pacemaker population Eur. Heart J., June 2, 2003; 24(12): 1143 - 1152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Peschar, H. de Swart, K. J. Michels, R. S. Reneman, and F. W. Prinzen Left ventricular septal and apex pacing for optimal pump function in canine hearts J. Am. Coll. Cardiol., April 2, 2003; 41(7): 1218 - 1226. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. E. Maurer, B. Naegeli, E. Straumann, O. Bertel, and J. Frielingsdorf Quality of life and exercise capacity in patients with prolonged PQ interval and dual chamber pacemakers: a randomized comparison of permanent ventricular stimulation vs intrinsic AV conduction Europace, January 1, 2003; 5(4): 411 - 417. [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]
|
|
|
|
|
|
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]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
