TY - JOUR
T1 - Single versus dual chamber pacing in the young
T2 - Noninvasive comparative evaluation of cardiac function
AU - Horenstein, M. Silvana
AU - Karpawich, Peter P.
AU - Tantengco, M. Victoria T.
PY - 2003/5/1
Y1 - 2003/5/1
N2 - 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.
AB - 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.
KW - Atrial synchrony
KW - Cardiac function
KW - Pediatric pacing
UR - http://www.scopus.com/inward/record.url?scp=0038404843&partnerID=8YFLogxK
U2 - 10.1046/j.1460-9592.2003.t01-1-00170.x
DO - 10.1046/j.1460-9592.2003.t01-1-00170.x
M3 - Article
C2 - 12765448
AN - SCOPUS:0038404843
VL - 26
SP - 1208
EP - 1211
JO - Pacing and Clinical Electrophysiology
JF - Pacing and Clinical Electrophysiology
SN - 0147-8389
IS - 5
ER -