Abstract:
:Dual-chamber pacing improved hemodynamics acutely in a subset of patients with left ventricular (LV) dysfunction but conveyed no long-term symptomatic benefit in most. More recently, LV pacing and biventricular (multisite) pacing have been used to improve systolic contractility by altering the electrical and mechanical ventricular activation sequence in patients with severe congestive heart failure (CHF) and intraventricular conduction delay or left bundle branch block (LBBB). Intraventricular conduction delay and LBBB cause dyssynchronous right ventricular and LV contraction and worsen LV dysfunction in cardiomyopathies. Both LV and biventricular cardiac pacing are thought to improve cardiac function in this situation by effecting a more coordinated and efficient ventricular contraction. Short-term hemodynamic studies have shown improvement in LV systolic function, which seems more pronounced with monoventricular LV pacing than with biventricular pacing. Recent clinical studies in limited numbers of patients suggest long-term clinical benefit of biventricular pacing in patients with severe CHF symptoms. Continuing and future studies will demonstrate whether and in which patients LV and biventricular pacing are permanently effective and equivalent and which pacing site within the LV produces the most beneficial hemodynamic results.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Gerber TC,Nishimura RA,Holmes DR Jr,Lloyd MA,Zehr KJ,Tajik AJ,Hayes DLdoi
10.1016/S0025-6196(11)63225-4keywords:
subject
Has Abstractpub_date
2001-08-01 00:00:00pages
803-12issue
8eissn
0025-6196issn
1942-5546pii
S0025-6196(11)63225-4journal_volume
76pub_type
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