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| Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function? |
| Kang Chen, Ye Mao, Shao-hua Liu, Qiong Wu, Qing-zhi Luo, Wen-qi Pan, Qi Jin, Ning Zhang, Tian-you Ling, Ying Chen, Gang Gu, Wei-feng Shen, Li-qun Wu |
| Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Outpatient Department, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China |
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Abstract Objective: We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function. Methods: Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Results: Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%–40% (for all comparisons, P<0.05). However, clinical function capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold. Conclusions: RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%.
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Received: 09 February 2014
Published: 07 June 2014
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Cite this article:
Kang Chen, Ye Mao, Shao-hua Liu, Qiong Wu, Qing-zhi Luo, Wen-qi Pan, Qi Jin, Ning Zhang, Tian-you Ling, Ying Chen, Gang Gu, Wei-feng Shen, Li-qun Wu. Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function?. Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2014, 15(6): 507-514.
URL:
http://www.zjujournals.com/xueshu/zjus-b/10.1631/jzus.B1400034 OR http://www.zjujournals.com/xueshu/zjus-b/Y2014/V15/I6/507
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