Journal of Cardiovascular Imaging

  • 제19권1호
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  • Pages.15-20
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  • 2011
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  • 2586-7210(pISSN)
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  • 2586-7296(eISSN)
한국심초음파학회 (Korean Society of Echocardiography)
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COMPARISON OF VENTRICULAR DYSSYNCHRONY ACCORDING TO THE POSITION OF RIGHT VENTRICULAR PACING ELECTRODE: A MULTI-CENTER PROSPECTIVE ECHOCARDIOGRAPHIC STUDY

  • Cho, Goo-Yeong (Cardiovascular Center, Seoul National University Bundang Hospital) ;
  • Kim, Mi-Jeong (Division of Cardiology, Incheon St. Mary's Hospital, The Catholic University Korea) ;
  • Park, Jae-Hyeong (Department of Internal Medicine, Chungnam National University School of Medicine) ;
  • Kim, Hyun-Sook (Division of Cardiology, Hallym University College of Medicine) ;
  • Youn, Hyun-Ju (Heart Center, Chonnam National University Medical School) ;
  • Kim, Kye-Hun (Heart Center, Chonnam National University Medical School) ;
  • Song, Jae-Kwan (Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2011.03.27
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Conventional pacemaker implantation induces left ventricular (LV) dyssynchrony, which might affect the LV function. We sought to evaluate the impact of different right ventricular (RV) pacing sites on the LV dyssynchrony and performance. Methods: Comprehensive echocardiographic evaluation including the atrio-ventricular, inter- and intra-ventricular dyssynchrony based on M-mode, conventional Doppler and tissue Doppler imaging (TDI) was done before and immediately after (< 7 days) pacemaker implantation. For the LV performance, LV ejection fraction, longitudinal peak systolic velocity at the mitral annulus (S') annular or mean longitudinal velocity of the 6 basal segments (Sm) were used. These results were compared with those of 15 age matched controls. Results: A total of 79 patients (48 females, mean age 63 ${\pm}$ 12 years) underwent RV pacing at the apex (n = 45, group I) or the septum (n = 34, group II). After pacemaker implantation, the QRS duration was significantly increased in both groups, but the change was greater in group I (57.1 ${\pm}$ 28.3 versus 32.8 ${\pm}$ 40.5 msec). Both the S' and Sm were lower in pacing groups than those in controls and Sm was significantly higher in group II (4.2 ${\pm}$ 1.0 versus 4.9 ${\pm}$ 1.3 m/sec) than group I despite a similar LV ejection fraction. The aortic pre-ejection time and septal to posterior wall motion delay in patients with pacemaker were longer compared to normal controls, but there were no significant differences. Both the TDI velocity and strain analysis showed no difference of the dyssynchrony indices between the two groups, despite a higher tendency of Doppler strain dyssynchrony indices in the RV apical pacing group compared to those of the control. Conclusion: Despite the marked increase of the QRS duration after pacing, M-mode, Doppler and TDI failed to demonstrate any difference according to the pacing sites. The long-term effect of the longitudinal contraction being less affected and a smaller increase of the QRS duration in the RV septal pacing group needs to be confirmed in a longitudinal follow-up study.

키워드

참고문헌

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피인용 문헌

  1. Heart failure due to right ventricular apical pacing: the importance of flow patterns vol.18, pp.11, 2011, https://doi.org/10.1093/europace/euw024
  2. Radial left ventricular dyssynchrony by speckle tracking in apical versus non apical right ventricular pacing- evidence of dyssynchrony on medium term follow up vol.8, pp.1, 2011, https://doi.org/10.15171/jcvtr.2016.04
  3. Different lead locations guided by fluoroscopy and ECG parameters and their effect on patients functional status vol.71, pp.1, 2011, https://doi.org/10.1186/s43044-019-0023-1
  4. Ventricular Dyssynchrony based on echocardiographic variables and exercise tolerance After right ventricular pacing: Impact of alternative septal lead locations vol.37, pp.2, 2011, https://doi.org/10.1111/echo.14585