Acute simultaneous biventricular or LV-first pacing with longer AV intervals reduced mechanical dyssynchrony and improved hemodynamics compared to normal sinus rhythm (p<0.05).
Does acute biventricular pacing improve hemodynamics and reduce mechanical dyssynchrony in heart failure patients with normal ejection fraction and mechanical dyssynchrony?
Acute biventricular or LV-first pacing with optimized AV intervals improves hemodynamics and reduces dyssynchrony in HFpEF patients with mechanical dyssynchrony.
valor p: p=<0.05
OBJECTIVES: We tested the acute effects of resynchronization in heart failure patients with a normal (>50%) left ventricular (LV) ejection fraction (HFNEF) and mechanical dyssynchrony. METHODS: Twenty-four HFNEF patients (72 ± 6 years, 5 male) with mechanical dyssynchrony (standard deviation of electromechanical time delay among 12 LV segments >35 ms) were studied with temporary pacing catheters in the right atrium, LV, and right ventricle (RV), and high-fidelity catheters for pressure recording. Using selected atrioventricular (AV) intervals of 60, 90, 120, 150, and 180 ms to optimize transmitral flow during simultaneous biventricular pacing, the RV-LV (VV) interval was then evaluated at RV30, RV15, 0, LV15, LV30, and LV45 (RV or LV indicates which ventricle was paced first, the number indicates by how many ms). RESULTS: During simultaneous pacing, longer AV intervals were associated with improved LV pressure-derivative minimums and increased aortic pressures (p < 0.05 vs. normal sinus rhythm). In the VV interval from RV30 to LV45, there was a graded increase in the aortic velocity time integral and a decrease in dyssynchrony during simultaneous or LV-first pacing (p < 0.05 vs. normal sinus rhythm). CONCLUSIONS: For HFNEF patients with mechanical dyssynchrony, acute simultaneous biventricular or LV-first pacing with longer AV intervals reduced mechanical dyssynchrony and improved diastolic and systolic hemodynamics.
Wang et al. (Thu,) conducted a other in Heart failure with normal ejection fraction (HFNEF) and mechanical dyssynchrony (n=24). Simultaneous biventricular or LV-first pacing vs. Normal sinus rhythm was evaluated on Diastolic and systolic hemodynamics and mechanical dyssynchrony (p=<0.05). Acute simultaneous biventricular or LV-first pacing with longer AV intervals reduced mechanical dyssynchrony and improved hemodynamics compared to normal sinus rhythm (p<0.05).