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Updated: Jul 7, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Biventricular pacing improves the blunted force-frequency relation present during univentricular pacing in patients

Dirk Vollmann1, Lars Lüthje, Peter Schott

  • 1Department of Cardiology and Pneumology, Georg-August-University, Göttingen, Germany. DirkVollmann2000@aol.com

Circulation
|February 16, 2006
PubMed

Insights

Biventricular pacing improves heart function as heart rate increases in chronic heart failure patients, unlike single-site pacing. This suggests biventricular pacing offers a functional benefit for resynchronization therapy.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Heart Failure Management

Background:

  • Patients with chronic heart failure (CHF) and conduction delay often have impaired systolic function.
  • Biventricular (BiV) and left ventricular (LV) pacing improve systolic function at rest in these patients.
  • The effect of pacing on contractile function at increasing heart rates is not well understood.

Purpose of the Study:

  • To investigate the differential effects of BiV and univentricular pacing on cardiac contractile function at increasing heart rates in CHF patients.
  • To compare the force-frequency relationship during BiV, LV, and right ventricular (RV) pacing.

Main Methods:

  • Twenty-two CHF patients underwent cardiac catheterization.
  • Left ventricular (LV) hemodynamics were measured during BiV, LV, and RV stimulation at varying heart rates (80, 100, 120, 140 bpm).
  • Key parameters assessed included LV end-diastolic pressure (LVEDP), LV systolic pressure (LVSP), and dP/dtmax.

Main Results:

  • BiV and LV pacing equally augmented dP/dtmax at 80 bpm compared to baseline and RV pacing.
  • Increasing heart rate from 80 to 140 bpm significantly enhanced dP/dtmax during BiV pacing.
  • No significant improvement in contractility was observed during single-site LV or RV pacing as heart rate increased.
  • At 140 bpm, BiV pacing resulted in lower LVEDP and higher LVSP compared to RV and LV pacing.

Conclusions:

  • Ventricular stimulation modes alter the in vivo force-frequency relation in CHF patients.
  • Contractile function improves with increasing heart rates during BiV stimulation, unlike single-site pacing.
  • This enhanced response may contribute to improved exercise capacity and offers a potential benefit over LV-only pacing for cardiac resynchronization therapy.
Abstract

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