Comparative study of the effect of pacing mode on the interaction of the right and left ventricles

被引：0
作者：
Mizutani N. [1 ]
Waseda K. [1 ]
Itou T. [1 ]
机构：
[1] Division of Cardiology, Department of Medicine, Aichi Med. Univ. School of Medicine, Nagakute, Aichi-gun, Aichi 480-1195
来源：
Journal of Artificial Organs | 2004年 / 7卷 / 2期
关键词：
Dual-peak waveform of RV dp/dt; Pacing mode; Resynchronization of right and left ventricles; Ventricle dyssynchrony;
D O I：
10.1007/s10047-004-0250-3
中图分类号：
学科分类号：
摘要：
This study was designed to evaluate ventricular dyssynchrony from the viewpoint of the interaction of right and left ventricular contractions. Forty-three patients, 24 with sick sinus syndrome, 9 with complete atrioventricular block, and 10 with normal sinus rhythm were involved in this study. Microtip transducer catheters were advanced into both the left and right ventricles and ventricular pressure and the associated dp/dt were recorded simultaneously. Hemodynamic differences in various pacing modes were analyzed using pressure and dp/dt recordings obtained from the left and right ventricles. When an asynchrony between the right and left ventricular contractions existed, the right ventricular positive peak dp/dt developed a dualpeak waveform, the second peak corresponding in time to the peak of the left ventricular positive peak dp/dt. This dual-peak dp/dt waveform was seen with ventricular (VVI) and atrioventricular sequential (DVI) pacing, whereas a single-peak waveform was seen with atrial (AAI) pacing or sinus rhythm. In cases where DVI or VVI pacing modes are selected, an asynchronous effect between contractions of the right and left ventricles may occur, with dual-peak dp/dt of the right ventricle. Because the dual-peak dp/dt waveform indicates ventricular dyssynchrony, reducing the distance from peak I to peak II could maintain the synchronization of the right and left ventricles. It is considered particularly vital to give sufficient consideration to this point in chronic heart failure patients with left bundle branch block requiring biventricular pacing.
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页码：77 / 82
页数：5
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共 17 条
  • [11] Feneley M.P., Gavaghan T.P., Baron D.W., Branson J.A., Roy P.R., Morgan J.J., Contribution of left ventricular contraction to the generation of right ventricular systolic pressure in the human heart, Circulation, 71, pp. 473-480, (1985)
  • [12] Oboler A.A., Keefe J.B., Gaasch W.H., Banas Jr. J.S., Levine H.J., Influence of left ventricular isovolumic pressure upon right ventricular pressure transients, Cardiology, 58, pp. 32-44, (1973)
  • [13] Armour J.A., Pace J.B., Randall W.C., Interrelationship of architecture and function of right ventricle, Am J Physiol, 2108, pp. 174-179, (1970)
  • [14] Robb J.S., Robb R.S., The normal heart: Anatomy and physiology of the structural units, Am Heart J, 23, pp. 455-467, (1942)
  • [15] Santamore W.P., Lynch P.R., Heckman J.L., Bove A.A., Meier G.D., Left ventricular effects on right ventricular developed pressure, J Appl Physiol, 41, pp. 925-930, (1976)
  • [16] Sogaard P., Egeblad H., Pedersen A.K., Kim W.Y., Kristensen B.O., Hansen P.S., Mortensen F.T., Sequential versus simultaneous biventricular resynchronization for severe heart failure: Evaluation by tissue Doppler imaging, Circulation, 106, pp. 2078-2084, (2002)
  • [17] Neri G., Zanco P., Zanon F., Buchberger R., Effect of biventricular pacing on metabolism and perfusion in patients affected by dilated cardiomyopathy and left bundle branch block: Evaluation by positron emission tomography, Europace, 5, pp. 11-115, (2003)
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