Can right-sided atrioventricular sequential pacing provide benefit for selected patients with severe congestive heart failure?

摘要: Abstract This study reports on the methods and results of applying right-sided atrioventricular (AV) pacing in 26 patients with advanced cardiomyopathy. Ten these had ischemic Of 16 nonischemic cardiomyopathy, 10 were idiopathic 6 due to secondary causes. The a mean age 56 ± 12 years left ventricular ejection fraction 11%. Two transvenous stimulation electrodes temporarily placed high right atrium ventricle, respectively. A Swan Ganz catheter was positioned into pulmonary artery determine cardiac output by thermodilution method measure pressure atrium. In addition, aortic measured through sheath via femoral artery. Systemic vascular resistance calculated. Stimulation performed VVI DDD modes using different AV intervals (40, 80, 125, 150, 175, 200, 250 msec). No increase observed for overall cohort (p = 0.51). At pacing, stroke volume significantly decreased from 66 20 mL 53 13 1L/min (n 12, 46%) nonresponders 14, 54%). Etiology either or cardiomyopathy responders, as well conduction disturbances (first-degree block, LBBB, RBBB), equally distributed among both groups. Using an delay 150 175 msec, responders derived significant output. An msec produced decrease systemic resistance. 46% dilated origin, AV-sequential brought about improvement function terms enhanced We suggest individual testing all severe dysfunction find responders.