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Ventricular contraction abnormalities in dilated cardiomyopathy: effect of biventricular pacing to correct

W F Kerwin1, E H Botvinick, J W O'Connell

  • 1Department of Medicine, University of California, San Francisco, USA.

Journal of the American College of Cardiology
|April 12, 2000
PubMed

Insights

Biventricular pacing significantly improves ventricular synchrony and ejection fraction in patients with dilated cardiomyopathy and conduction delays. This coordinated contraction pattern enhances heart function.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Imaging

Background:

  • Dilated cardiomyopathy (DCM) is characterized by impaired ventricular activation and contraction.
  • Biventricular pacing (BiV) is a potential therapeutic strategy to improve ventricular coordination in DCM patients.
  • This study investigates the impact of BiV on interventricular synchrony and ejection fraction in DCM.

Purpose of the Study:

  • To quantify ventricular contractile synchrony in patients with DCM.
  • To assess the effects of biventricular pacing on synchrony and ejection fraction.
  • To evaluate the correlation between improved synchrony and ejection fraction.

Main Methods:

  • Thirteen DCM patients with intraventricular conduction delay were studied.
  • Multiple gated equilibrium blood pool scintigraphy with phase image analysis was employed.
  • Interventricular (RV/LV) synchrony was measured in sinus rhythm and during BiV.

Main Results:

  • Interventricular dyssynchrony in sinus rhythm correlated with lower LV ejection fraction.
  • BiV significantly improved interventricular synchrony (27.5° to 14.1°, p=0.01).
  • LV ejection fraction increased significantly (17.2% to 22.5%, p<0.0001) and correlated with synchrony improvement (r=0.86, p<0.001).

Conclusions:

  • DCM with conduction delay is linked to substantial interventricular dyssynchrony.
  • Biventricular pacing enhances interventricular synchrony in these patients.
  • Improved synchrony during BiV acutely correlates with enhanced LV ejection fraction.
Abstract

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