Effect of Pacing Chamber and Atrioventricular Delay on Acute Systolic Function of Paced Patients With Congestive Heart Failure

• DOI: 10.1161/01.cir.99.23.2993
• Publication Date: 2012-06-12T00:42:29Z
• Authors: Angelo Auricchio; Christoph Stellbrink; Michael Block; Stefan Sack; Jürgen Vogt; Patricia Bakker; Helmut Klein; Andrew Kramer; Jiang Ding; Rodney Salo; Bruce Tockman; Thierry Pochet; Julio Spinelli
• Keywords: Econometric and Statistical Methods: General; Other medical specialities; 03 medical and health sciences; 0302 clinical medicine; Bescherming en bevordering van de menselijke gezondheid; Geneeskunde(GENK); 3. Good health

Background —Previous studies of pacing therapy for dilated congestive heart failure (CHF) have not established the relative importance site, AV delay, and patient heterogeneity on outcome. These variables were compared by a novel technique that evaluated immediate changes in hemodynamic function during brief periods atrial-synchronous ventricular pacing. Methods Results —Twenty-seven CHF patients with severe left (LV) systolic dysfunction LV conduction disorder implanted endocardial leads right atrium ventricle (RV) an epicardial lead instrumented micromanometer catheters LV, aorta, RV. Patients normal sinus rhythm stimulated RV, or both ventricles simultaneously (BV) at preselected delays repeating 5-paced/15-nonpaced beat sequence. Maximum pressure derivative (LV+dP/dt) aortic pulse (PP) changed immediately onset, increasing patient-specific optimal delay 20 wide surface QRS (180±22 ms) decreasing short 5 narrower (128±12 ( P <0.0001). Overall, BV increased LV+dP/dt PP more than RV <0.01), whereas <0.01). Conclusions —In this population, sufficiently benefit from pacing, stimulation is required maximum acute benefit, any site occurs delay.