Further deterioration of LV ejection fraction and mechanical synchrony during RV apical pacing in patients with heart failure and LBBB

Daniel R. Ludwig, Hidekazu Tanaka, Mati Friehling, John Gorcsan, David Schwartzman

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Electrocardiographic left bundle branch block (LBBB) may be due to intrinsic disease of the left bundle branch or induced by right ventricular apical (RVA) pacing. Prior reports clearly delineate the derogatory impact of LBBB on left ventricular (LV) mechanical function but suggest equivalent impact between varieties. We hypothesized that their effects were disparate and performed a within-patient comparison to test this notion. Patients (n = 20) with heart failure, intrinsic LBBB, and an implanted pacing device with right atrial and RVA leads were studied. Each patient underwent transthoracic three-dimensional speckle-tracking echocardiography during atrial pacing (intrinsic LBBB) and short atrioventricular delay atrial-RVA pacing, and these studies were compared. Relative to intrinsic LBBB, RVA pacing-induced LBBB produced greater intra-LV and interventricular dyssynchrony, a deterioration in LV function, and a shift in the site of latest activation. In patients with heart failure and LBBB, acute RVA pacing induces greater mechanical dyssynchrony and further impairs LV function.

Original languageEnglish (US)
Pages (from-to)425-429
Number of pages5
JournalJournal of cardiovascular translational research
Volume6
Issue number3
DOIs
StatePublished - Jun 2013

All Science Journal Classification (ASJC) codes

  • Molecular Medicine
  • Genetics
  • Pharmaceutical Science
  • Cardiology and Cardiovascular Medicine
  • Genetics(clinical)

Fingerprint

Dive into the research topics of 'Further deterioration of LV ejection fraction and mechanical synchrony during RV apical pacing in patients with heart failure and LBBB'. Together they form a unique fingerprint.

Cite this