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J Am Coll Cardiol, 2006; 48:1642-1648, doi:10.1016/j.jacc.2006.05.072 (Published online 26 September 2006).
© 2006 by the American College of Cardiology Foundation
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Right Ventricular Pacing Can Induce Ventricular Dyssynchrony in Patients With Atrial Fibrillation After Atrioventricular Node Ablation

Laurens F. Tops, MD, Martin J. Schalij, MD, PhD, Eduard R. Holman, MD, PhD, Lieselot van Erven, MD, PhD, Ernst E. van der Wall, MD, PhD and Jeroen J. Bax, MD, PhD*

Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.


Figure 1
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  		Figure 1 A linear relation was found between septal-to-posterior wall motion delay (SPWMD) and septal-to-lateral delay after long-term right ventricular pacing.

 

Figure 2
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  		Figure 2 Septal-to-posterior wall motion delay (SPWMD) and septal-to-lateral delay after long-term right ventricular pacing. For left ventricular dyssynchrony, a cutoff value of SPWMD ≥130 ms (dashed line), and septal-to-lateral delay ≥65 ms (solid line) was used. There is a good agreement between SPWMD and septal-to-lateral delay. In only 4 patients, there was a disagreement between SPWMD and septal-to-lateral delay.

 

Figure 3
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  		Figure 3 Effects of long-term right ventricular (RV) pacing on clinical status and left ventricular ejection fraction (LVEF). (A) In patients with LV dyssynchrony, New York Heart Association (NYHA) functional class deteriorated significantly, whereas NYHA functional class improved significantly in patients without LV dyssynchrony. (B) LV ejection fraction decreased significantly in patients with LV dyssynchrony after long-term RV pacing. *p < 0.05 baseline versus follow-up; {dagger}p < 0.05 with dyssynchrony versus without dyssynchrony. White columns = baseline; black columns = follow-up.

 
 
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