What Are the Clinical Benefits of Biventricular Pacing in Heart Failure Patients

摘要: The conventional DDD mode of pacing, using the right ventricular (RV) apex as usual site depolarization, results in retrograde activation left ventricle (LV). This opposite electrical sequence produces deleterious hemodynamic effects well bundle branch block regularly associated with dilated cardiomyopathy [1]. Optimization atrioventricular delay (AVD) provides a better LV filling pattern but does not always compensate RV pacing consequences [2]. Biventricular (BV) was therefore developed to prevent interventricular dyssynchrony and, potentially, intraventricular dyssynchrony. BV initially demonstrated provide acute improvement patients severe congestive heart failure (CHF) prolonged QRS duration [3–5]. With first clinical studies revealed an diminution capillary wedge pressure cardiac index, suggesting regression symptoms. However, potential benefits were only confirmed at mid-term follow-up.