OBJECTIVES: To quantify the short term haemodynamic effects of biventricular pacing in patients with heart failure and left bundle branch block by using three dimensional echocardiography. DESIGN: Three dimensional echocardiography was performed in 15 consecutive heart failure patients (New York Heart Association functional class III or IV) with an implanted biventricular pacing system. Six minute walk tests were performed to investigate the effect of biventricular pacing on exercise capacity. Data were acquired at sinus rhythm and after short term (2-7 days) biventricular pacing. RESULTS: Compared with baseline values, biventricular pacing significantly reduced left ventricular end diastolic volume (EDV) by mean (SD) 4.0 (5.1)% (p < 0.01) and end systolic volume (ESV) by 5.6 (6.4)% (p < 0.02). Mitral regurgitant fraction was significantly reduced by 11 (12.1)% (p < 0.003) and forward stroke volume (FSV) increased by 13.9 (18.6)% (p < 0.02). Exercise capacity was significantly improved with biventricular pacing by 48.4 (43.3)% (p < 0.00001). Regression analyses showed that the percentage increase in FSV independently predicted percentage improvement in walking distance (r(2) = 0.73, p < 0.0002). Both basal QRS duration and QRS narrowing predicted pacing efficacy, showing a significant correlation with %DeltaEDV, %DeltaESV, and %DeltaFSV. CONCLUSIONS: In five of 15 consecutive patients with heart failure and left bundle branch block, biventricular pacing induced a more than 15% increase in FSV, which predicted a more than 25% increase in walking distance and was accompanied by an immediate reduction in left ventricular chamber size and mitral regurgitation.
OBJECTIVES: To quantify the short term haemodynamic effects of biventricular pacing in patients with heart failure and left bundle branch block by using three dimensional echocardiography. DESIGN: Three dimensional echocardiography was performed in 15 consecutive heart failurepatients (New York Heart Association functional class III or IV) with an implanted biventricular pacing system. Six minute walk tests were performed to investigate the effect of biventricular pacing on exercise capacity. Data were acquired at sinus rhythm and after short term (2-7 days) biventricular pacing. RESULTS: Compared with baseline values, biventricular pacing significantly reduced left ventricular end diastolic volume (EDV) by mean (SD) 4.0 (5.1)% (p < 0.01) and end systolic volume (ESV) by 5.6 (6.4)% (p < 0.02). Mitral regurgitant fraction was significantly reduced by 11 (12.1)% (p < 0.003) and forward stroke volume (FSV) increased by 13.9 (18.6)% (p < 0.02). Exercise capacity was significantly improved with biventricular pacing by 48.4 (43.3)% (p < 0.00001). Regression analyses showed that the percentage increase in FSV independently predicted percentage improvement in walking distance (r(2) = 0.73, p < 0.0002). Both basal QRS duration and QRS narrowing predicted pacing efficacy, showing a significant correlation with %DeltaEDV, %DeltaESV, and %DeltaFSV. CONCLUSIONS: In five of 15 consecutive patients with heart failure and left bundle branch block, biventricular pacing induced a more than 15% increase in FSV, which predicted a more than 25% increase in walking distance and was accompanied by an immediate reduction in left ventricular chamber size and mitral regurgitation.
Authors: Y Otsuji; M D Handschumacher; E Schwammenthal; L Jiang; J K Song; J L Guerrero; G J Vlahakes; R A Levine Journal: Circulation Date: 1997-09-16 Impact factor: 29.690
Authors: G S Nelson; C W Curry; B T Wyman; A Kramer; J Declerck; M Talbot; M R Douglas; R D Berger; E R McVeigh; D A Kass Journal: Circulation Date: 2000-06-13 Impact factor: 29.690
Authors: A Auricchio; C Stellbrink; M Block; S Sack; J Vogt; P Bakker; H Klein; A Kramer; J Ding; R Salo; B Tockman; T Pochet; J Spinelli Journal: Circulation Date: 1999-06-15 Impact factor: 29.690
Authors: M L Chuang; M G Hibberd; C J Salton; R A Beaudin; M F Riley; R A Parker; P S Douglas; W J Manning Journal: J Am Coll Cardiol Date: 2000-02 Impact factor: 24.094
Authors: C Alonso; C Leclercq; F Victor; H Mansour; C de Place; D Pavin; F Carré; P Mabo; J C Daubert Journal: Am J Cardiol Date: 1999-12-15 Impact factor: 2.778
Authors: C Leclercq; S Cazeau; H Le Breton; P Ritter; P Mabo; D Gras; D Pavin; A Lazarus; J C Daubert Journal: J Am Coll Cardiol Date: 1998-12 Impact factor: 24.094
Authors: Himanshu H Shukla; Erskine A James; John A Schutz; Benjamin F Lloyd; Greg C Flaker Journal: J Interv Card Electrophysiol Date: 2003-12 Impact factor: 1.900
Authors: P Kiès; C Leclercq; G B Bleeker; C Crocq; S G Molhoek; C Poulain; L van Erven; M Bootsma; K Zeppenfeld; E E van der Wall; J-C Daubert; M J Schalij; J J Bax Journal: Heart Date: 2005-09-13 Impact factor: 5.994
Authors: C M C van Campen; Frans C Visser; Arno P van der Weerdt; Paul Knaapen; Emile F I Comans; Adriaan A Lammertsma; Carel C de Cock; Cees A Visser Journal: Eur J Nucl Med Mol Imaging Date: 2006-09-26 Impact factor: 9.236
Authors: Grzegorz Piotrowski; Piotr Szymański; Maciej Banach; Aneta Piotrowska; Rafał Gawor; Jacek Rysz; Zenon Gawor Journal: Arch Med Sci Date: 2010-12-29 Impact factor: 3.318