Impact of Conventional Versus Biventricular Pacing on Hemodynamics and Tissue Doppler Imaging Indexes of Resynchronization Postoperatively in Children With Congenital Heart Disease
Phat P. Pham, MD,
Seshadri Balaji, MBBS, MRCP (UK), FACC,
Irving Shen, MD, FACC,
Ross Ungerleider, MD, FACC,
Xiaokui Li, MD and
David J. Sahn, MD, MACC*
Oregon Health and Science University, Portland, Oregon
View larger version (101K):
[in a new window]
|
Figure 1 Temporary epicardial leads for pacing protocol. Standard right atrial (RA) leads, one active (–) and one indifferent (+) lead. Two right ventricular (RV) leads, RV base (–), RV apex (+). One left ventricular (LV) free wall lead (–). Atrial pacing (AOO) mode uses RA leads only. Conventional dual-chamber pacing (CDOO) uses RA and RV leads. Biventricular pacing (BDOO) uses RA, RV, and LV leads.
|
|
View larger version (88K):
[in a new window]
|
Figure 2 A 10-lead electrocardiogram of Patient #13 shows narrow QRS complexes with atrial pacing (AOO) and widened QRS complexes with conventional dual-chamber pacing (CDOO) and biventricular pacing (BDOO).
|
|
View larger version (133K):
[in a new window]
|
Figure 3 Still images of an apical four-chamber two-dimensional view and tissue Doppler-derived strain rate color map (left). The graph shows a typical longitudinal strain rate with the mechanical events of the left (LV) and right ventricle (RV) during conventional dual-chamber pacing. HR = heart rate; IVT = isovolumic tensing; PSC = peak systolic contraction; SR = strain rate; SRI = strain rate index; V = ventricle.
|
|
|
