Left ventricular and biventricular pacing in congestive heart failure.

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 Proc

journal_title

Mayo Clinic proceedings

authors

Gerber TC,Nishimura RA,Holmes DR Jr,Lloyd MA,Zehr KJ,Tajik AJ,Hayes DL

doi

10.1016/S0025-6196(11)63225-4

keywords:

subject

Has Abstract

pub_date

2001-08-01 00:00:00

pages

803-12

issue

8

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(11)63225-4

journal_volume

76

pub_type

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