BACKGROUND: Left ventricular (LV) pacing has been suggested to complement other forms of therapy in patients with heart failure. METHODS AND RESULTS: We investigated 17 patients (15 men, 2 women, aged 68 +/- 6 years, 10 ischemic and 7 primary dilated cardiomyopathy) with heart failure (13 were in New York Heart Association class IV and 4 in class III). One month after LV pacer implantation, 12 patients reported clinical improvement (mean class 3.7 before pacing vs 2.6 with LV pacing; P = .001). We report the results of 3 equilibrium-gated blood pool studies performed in each patient, 1 before pacing and 2 after pacer implantation (1 with pacing on, and 1 after turning off the pacer). LV pacing did not modify LV ejection fraction. Phase analysis demonstrated a significant decrease of the interventricular phase shift (delta(pi)) with LV pacing (no pacing, delta(pi) = 8.99 degrees +/- 19.05 degrees; delta7n= -0.97 degrees +/- 27.85 degrees with LV pacing). Clinical improvement was observed in patients with an initial positive delta(pi) that decreased with pacing and/or an initial LV phase standard deviation >50 degrees that decreased with pacing. CONCLUSION: LV pacing induces interventricular and intraventricular synchronization. A decrease of the interventricular phase shift seems to be the most important predictor of functional recovery for paced patients with heart failure.
BACKGROUND: Left ventricular (LV) pacing has been suggested to complement other forms of therapy in patients with heart failure. METHODS AND RESULTS: We investigated 17 patients (15 men, 2 women, aged 68 +/- 6 years, 10 ischemic and 7 primary dilated cardiomyopathy) with heart failure (13 were in New York Heart Association class IV and 4 in class III). One month after LV pacer implantation, 12 patients reported clinical improvement (mean class 3.7 before pacing vs 2.6 with LV pacing; P = .001). We report the results of 3 equilibrium-gated blood pool studies performed in each patient, 1 before pacing and 2 after pacer implantation (1 with pacing on, and 1 after turning off the pacer). LV pacing did not modify LV ejection fraction. Phase analysis demonstrated a significant decrease of the interventricular phase shift (delta(pi)) with LV pacing (no pacing, delta(pi) = 8.99 degrees +/- 19.05 degrees; delta7n= -0.97 degrees +/- 27.85 degrees with LV pacing). Clinical improvement was observed in patients with an initial positive delta(pi) that decreased with pacing and/or an initial LV phase standard deviation >50 degrees that decreased with pacing. CONCLUSION: LV pacing induces interventricular and intraventricular synchronization. A decrease of the interventricular phase shift seems to be the most important predictor of functional recovery for paced patients with heart failure.
Authors: M A Frais; E H Botvinick; D W Shosa; W J O'Connell; M M Scheinman; R S Hattner; F Morady Journal: Am J Cardiol Date: 1982-07 Impact factor: 2.778
Authors: E H Botvinick; M A Frais; D W Shosa; J W O'Connell; J A Pacheco-Alvarez; M Scheinman; R S Hattner; F Morady; D B Faulkner Journal: Am J Cardiol Date: 1982-08 Impact factor: 2.778
Authors: Mark A Trimble; Salvador Borges-Neto; Stuart Smallheiser; Ji Chen; Emily F Honeycutt; Linda K Shaw; Jaekyeong Heo; Robert A Pagnanelli; E Lindsey Tauxe; Ernest V Garcia; Fabio Esteves; Frank Seghatol-Eslami; G Neal Kay; Ami E Iskandrian Journal: J Nucl Cardiol Date: 2007-04-18 Impact factor: 5.952