Biventricular pacing decreases sympathetic activity compared with right ventricular pacing in patients with depressed ejection fraction

Citation
Mh. Hamdan et al., Biventricular pacing decreases sympathetic activity compared with right ventricular pacing in patients with depressed ejection fraction, CIRCULATION, 102(9), 2000, pp. 1027-1032
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
CIRCULATION
ISSN journal
0009-7322 → ACNP
Volume
102
Issue
9
Year of publication
2000
Pages
1027 - 1032
Database
ISI
SICI code
0009-7322(20000829)102:9<1027:BPDSAC>2.0.ZU;2-#
Abstract
Background-Although there have been few studies in which the hemodynamic ef fects of right ventricular (RV) and left ventricular (LV) pacing were compa red with those of biventricular (BV) pacing, the autonomic changes during t hese different pacing modes remain unknown. We hypothesized that BV pacing results in improved hemodynamics and a decrease in sympathetic nerve activi ty (SNA) compared with single-site pacing. Methods and Results-Thirteen men with a mean ejection fraction of 0.28+/-0. 7 were enrolled in the study. Arterial blood pressure (BP), central venous pressure (CVP), and SNA were recorded during 3 minutes of right atrial (RA) -RV, RA-LV, and RA-BV pacing at a rate 10 beats faster than sinus rhythm. B P was greater during LV (151+/-7/ 85+/-3 mm Hg) and BV (151+/-6/85+/-3 mm H g) pacing than during RV pacing (146+/-7/82+/-3 nm Hg) (P<0.05). There were no differences in CVP among all pacing modes (P=0.27). SNA was significant ly less (P<0.02) during both LV (606+/-35 U) and BV (582+/-41 U) pacing com pared with RV pacing (585+/-32 U) (P<0.02). Although not statistically sign ificant (P=0.08 to 0.14), there was a trend for patients with a narrow QRS to have a lower mean BP and higher SNA during LV pacing than during BV paci ng (r=0.42 to 0.49). Conclusions-LV-based pacing results in improved hemodynamics and a decrease in SNA compared with RV pacing in patients with LV dysfunction regardless of the QRS duration.