Prognostic Value of Pacing-Induced Mechanical Alternans in Patients With Mild-to-Moderate Idiopathic Dilated Cardiomyopathy in Sinus Rhythm
Akihiro Hirashiki, MD*, ,
Hideo Izawa, MD, PhD,
Fuji Somura, MD, PhD ,
Koji Obata, PhD*,
Tomoko Kato, MD, PhD,
Takao Nishizawa, MD, PhD*,
Akira Yamada, MD,
Hiroyuki Asano, MD,
Satoru Ohshima, MD,
Akiko Noda, PhD ,
Shigeo Iino, MD, PhD,
Kohzo Nagata, MD, PhD,
Kenji Okumura, MD, PhD,
Toyoaki Murohara, MD, PhD and
Mitsuhiro Yokota, MD, PhD, FACC*,*
* Department of Cardiovascular Genome Science, Nagoya University School of Medicine, Nagoya, Japan
Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
Nagoya Ekisaikai Hospital, Nagoya, Japan
Nagoya University School of Health Sciences, Nagoya, Japan
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Figure 1 Representative records of pacing-induced mechanical alternans. The traces represent a lead II electrocardiogram (ECG), left ventricular (LV) pressure, and LV dP/dt at a baseline heart rate (HR) of 66 beats/min (bpm) and at atrial pacing of 120 bpm for a male patient with idiopathic dilated cardiomyopathy. Alternating pressure was 30 mm Hg at the pacing rate of 120 bpm. Both LV dP/dtmax and LV dP/dtmin showed alternating changes with LV pressure. dP/dt = first derivative of left ventricular pressure.
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Figure 2 Cumulative probability of event-free survival calculated by the Kaplan-Meier method for all idiopathic dilated cardiomyopathy patients and patient groups A and B. The probability of event-free survival in group A was significantly greater than that in group B by the log-rank test (p = 0.021).
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