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Acute effects of single-site pacing from the left and right ventricle on ventricular function and

Mark K Friedberg1, Anne M Dubin, George F Van Hare

  • 1Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Stanford, Calif, USA.

Congenital Heart Disease
|September 11, 2009
PubMed

Insights

In children with normal heart function, pacing from the right ventricle (RV) apex, RV outflow, or left ventricle (LV) causes electrical dyssynchrony but does not significantly impact heart function or hemodynamics.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiac Physiology

Background:

  • Pacing in children can affect cardiac function and ventricular interactions.
  • Understanding the acute effects of different pacing sites is crucial for managing pediatric patients.

Purpose of the Study:

  • To evaluate the acute effects of right ventricular (RV) apical, RV outflow, and left ventricular (LV) pacing on LV and RV function and ventricular-ventricular interactions in children with normal cardiac function.

Main Methods:

  • Prospective, acute intervention study in a tertiary care electrophysiology laboratory.
  • Seven children (12 +/- 4 years) underwent pacing at baseline, RV apex, RV outflow, and LV.
  • Measurements included cardiac function (dP/dTmax, cardiac index), hemodynamics (blood pressure), QRS duration, and mechanical dyssynchrony via tissue Doppler imaging.

Main Results:

  • Pacing significantly prolonged QRS duration, indicating electrical dyssynchrony.
  • RV outflow pacing induced LV intraventricular delay, and RV apical pacing caused interventricular delay.
  • No significant changes were observed in cardiac index, blood pressure, or ventricular contractility/relaxation parameters.

Conclusions:

  • Single-site RV apical, RV outflow, and LV pacing in children with normal cardiac anatomy and function induce electromechanical dyssynchrony.
  • These pacing strategies do not significantly alter ventricular function, hemodynamics, or adversely affect ventricular-ventricular interactions.
Abstract

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