Skip Navigation

Europace 2005 7(3):287; doi:10.1016/j.eupc.2005.02.005
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Padeletti, L.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Padeletti, L.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

CP02: MYOCARDIAL PERFORMANCE EVALUATION AFTER RV APICAL PACING: THE "WHERE" STUDY

L. Padelettia, M. Santinib, A. Ravazzic, S. Orazid, F. Belloccie, F. Biscioneff on behalf of WHERE Clinical Investigation Group

a)Universitą di Firenze Florence, Italy; b)Ospedale S. Filippo Neri Rome, Italy; c)Ospedale SS. Antonio Biagio e Arrigo Alessandria, Italy; d)Ospedale Provinciale Rieti, Italy; e)Casa di Cura Villa Tiberia Rome, Italy; f)Ospedale S. Giacomo Rome

BACKGROUND: RV apical pacing has been shown to decrease LV performance, which can be assessed either by Echo or by a pacing system equipped with a microaccelerometer (Sorin Biomedica, Italy) able to measure Peak Endocardial Acceleration, PEA, and therefore to evaluate LVdP/dtmax.

AIM: This multicentre (26 European Centres), prospective, randomised, crossover, single-blind study compares, intra-patient, LV function in 2 different settings of DDDR programmation: maintained spontaneous AV conduction or RV pacing at Optimized AV Delay (OAVD).

METHODS: 103pts (67M, 73.1±9.1yrs) were implanted with a Sorin BEST-Living System for SSS, sinus bradycardia, with QRS<120ms, PR<220ms.After 1 month (baseline) pacemakers were randomly programmed for 2 successive periods of 6 months either pacing interval with OAVD or in spontaneous AV conduction. Group1 began with 6mos pacing; group2 with 6mos of spontaneous conduction. Echo and PEA assessments and Quality of Life (QOL) evaluation were performed (in spontaneous AV conditions) at baseline, crossover and at the end of the 2nd period.

RESULTS: 87pts completed the study with similar baseline values. LVEDD:47.8±5.4 (Group1-41pts) and 47.9±5.8 (Group2-46pts); PEA:0.93±0.5 (Group1) and 0.96±0.52 (Group2) (p=ns). Both in Group1 and Group2 LVEDD increased during pacing period (from 47.8±5.4 to 50.4±5.5 and from 44.9±5.7 to 47.7±6.5 respectively; p<0.05) and decrease during spontaneous conduction (from 50.4±5.5 to 46.4±5.8 and from 47.9±5.8 to 44.9±5.7 respectively; p<0.05). PEA values for both Group1 and Group 2 decreased during pacing period (from 0.93±0.5 to 0.73±0.5 and from 1.20±0.64 to 0.95±0.54 respectively; p<0.05) and increased during spontaneous conduction (from 0.73±0.5 to 1.10±0.56 and from 0.96±0.52 to 1.20±0.64 respectively; p<0.05).

CONCLUSIONS: 1)Echo/PEA data confirm that RV apical decreases LV performance (contractility)

2)QOL improves during spontaneous AV conduction.

3)PEA may be employed to monitor LV function evolution in paced patients, saving costs and time of Echo


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.