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Related Experiment Videos

Right ventricular pacing and left ventricular filling pattern. An echo-Doppler study.

M G Modena1, A V Mattioli, G Mattioli

  • 1Cattedra di Malattie Cardiovascolari, Università degli Studi di Modena, Italy.

Chest
|September 1, 1991
PubMed
Summary

Right ventricular pacing can alter left ventricular filling, particularly in patients without left bundle branch block. This pacing can cause interventricular asynchrony, lengthening diastolic filling times and mimicking abnormal relaxation patterns.

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Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Echocardiography

Background:

  • The impact of right ventricular pacing on left ventricular diastolic function remains incompletely understood.
  • Understanding these effects is crucial for managing patients with pacemakers.

Purpose of the Study:

  • To investigate the effects of right ventricular pacing on left ventricular filling dynamics.
  • To compare these effects in patients with and without spontaneous left bundle branch block.

Main Methods:

  • Doppler echocardiography was used to assess mitral valve inflow parameters.
  • Key measurements included isovolumic relaxation time (IVR), early (E) and late (A) peak velocities, E/A ratio, and deceleration time (Dec t).
  • Patients were studied at spontaneous rhythm and during right ventricular pacing.

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Main Results:

  • In patients with spontaneous left bundle branch block (Group A), right ventricular pacing did not significantly alter Doppler parameters.
  • In patients without left bundle branch block (Group B), electrical stimulation led to a significant lengthening of IVR and Dec t.
  • No significant differences in Doppler parameters were observed between groups at the same pacing frequency.

Conclusions:

  • Right ventricular pacing induces interventricular asynchrony, leading to abnormalities in diastolic filling times.
  • These abnormalities manifest as prolonged IVR and Dec t, simulating a pattern of impaired left ventricular relaxation.
  • The presence of spontaneous left bundle branch block may mitigate some of these pacing-induced diastolic changes.