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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
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[Right ventricular desynchronization in patients with pacemaker syndrome].

De-Zhen Zhou1, Fan-Ping Wei, Gao-Hui Yuan

  • 1Department of Cardiology, Huzhou Central Hospital, Huzhou 313000, China.

Zhonghua Xin Xue Guan Bing Za Zhi
|March 18, 2008
PubMed
Summary

Right ventricular desynchronization, not left, is key in pacemaker syndrome (PMS). This study used tissue Doppler imaging to assess ventricular function in patients with and without PMS, finding significant differences in RV timing. Understanding desynchronization aids in managing PMS.

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Pacemaker syndrome (PMS) is a clinical condition associated with pacemaker use.
  • Ventricular desynchronization can occur in patients with pacemakers, potentially leading to PMS.
  • Tissue Doppler imaging (TDI) is a valuable tool for assessing ventricular mechanics.

Purpose of the Study:

  • To investigate the incidence and characteristics of ventricular desynchronization in patients with and without pacemaker syndrome.
  • To compare ventricular desynchronization patterns between patients with PMS, without PMS, and a control group.

Main Methods:

  • Tissue Doppler imaging (TDI) was used to measure systolic peak velocity, acceleration, and time to peak velocity of the interventricular septum (IVS), left ventricular (LV), and right ventricular (RV) lateral walls.
  • The study included three groups: control (atrial fibrillation without pacemaker), patients with pacemakers without PMS, and patients with pacemakers and PMS.
  • Exclusion criteria included valve disease, myocardial infarction, severe pulmonary hypertension, low ejection fraction, significant hypokinesis, and complete bundle branch block.

Main Results:

  • Patients with pacemakers showed reduced systolic peak velocity and acceleration in LV and RV lateral walls compared to controls.
  • Time to peak velocity for IVS and LV lateral walls was prolonged in both PMS and non-PMS groups, while IVS and RV lateral wall time to peak velocity was shortened.
  • Significant differences in RV lateral wall time to peak velocity were observed between patients with and without PMS, suggesting RV desynchronization.

Conclusions:

  • Right ventricular (RV) desynchronization appears to play a more significant role in the development of pacemaker syndrome (PMS) than left ventricular (LV) desynchronization.
  • These findings highlight the importance of assessing RV mechanics in patients with pacemakers to identify and manage potential desynchronization.
  • Further research may focus on targeted interventions to mitigate RV desynchronization and improve outcomes in patients with PMS.