Single versus dual chamber pacing in the young: noninvasive comparative evaluation of cardiac function
UMass Chan Affiliations
Department of PediatricsDocument Type
Journal ArticlePublication Date
2003-05-27Keywords
AdolescentAdult
Cardiac Pacing, Artificial
Child
Echocardiography
Electrocardiography
Female
Heart Block
Humans
Male
Cardiology
Pediatrics
Metadata
Show full item recordAbstract
The advantages of atrial synchrony over asynchronous ventricular pacing remain unclear in the young, chronically right ventricular (RV) - paced patient. This is in contrast to the older patient with inherent diastolic dysfunction who has been shown to benefit from atrial synchrony with dual chamber (DDD,R/VDD), over single chamber rate response (VVI,R) ventricular pacing. The goal of this study was to noninvasively assess cardiac function in a group of young, RV-paced patients before and after establishment of atrial synchrony. Echocardiographic data were retrospectively analyzed from 10 patients with congenital or acquired complete AV block, who were VVI,R paced for 10.2 +/- 2 years (mean age at study 19.2 +/- 8.9 years), and were subsequently converted to DDD,R/VDD pacing (mean age at study 20.7 +/- 9.5 years). Paired t-test analysis of left ventricular (LV) systolic and diastolic function during VVI,R versus DDD,R/VDD pacing did not result in any short-term difference in LV short axis fractional area of change or FAC (53% +/- 7.5% vs 56.8% +/- 8.7%) or mitral maximal velocity (E) normalized to mitral flow velocity time integral (VTI) (5.2/s +/- 1.5 vs 4.4/s +/- 1.5). A decrease in mitral flow E/A ratio was observed after short-term DDD,R/VDD pacing (2.2 +/- 0.5 vs 1.9 +/- 0.3). Atrial synchronous dual chamber pacing in young patients with complete AV block does not lead to any appreciable early change in global LV function over single-site RV pacing. Therefore, early establishment of atrial synchrony in the young asymptomatic VVI,R-paced patient with normal intrinsic ventricular function may not be warranted.Source
Pacing Clin Electrophysiol. 2003 May;26(5):1208-11. DOI: 10.1046/j.1460-9592.2003.t01-1-00170.xDOI
10.1046/j.1460-9592.2003.t01-1-00170.xPermanent Link to this Item
http://hdl.handle.net/20.500.14038/43148PubMed ID
12765448Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1046/j.1460-9592.2003.t01-1-00170.x