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October 3, 2007EP EuropaceOpen Access

Single-site ventricular and biventricular pacing: investigation of latest depolarization strategy

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Why the study?

Does single-site RV pacing better preserve haemodynamic function and electrical activation compared to biventricular pacing in an acute swine model with normal anatomy and function?

Population

Acute swine model with normal anatomy and function (n=7)

Comparison

Endocardial single-site pacing from the right… vs Biventricular pacing and intrinsic activation

Design

Preclinical

Follow-up

5 minutes of consistent capture

Key result

Acute biventricular pacing in intact, synchronous swine hearts resulted in systolic dysfunction (P<0.05) and abnormal left ventricular electrical activation compared to intrinsic activation.

Authors

MKMichael W. KimmelNSNicholas D. SkadsbergCBCHARLES L. BYRD

Discussion

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Overview

Raises caution for biventricular pacing in normal hearts; leaves open translation to human conduction disease.

Structured PICO

Does single-site RV pacing better preserve haemodynamic function and electrical activation compared to biventricular pacing in an acute swine model with normal anatomy and function?

P
Population
Acute swine model with normal anatomy and function (n=7)
I
Intervention
Endocardial single-site pacing from the right ventricular (RV) septum and RV apex
C
Comparator
Biventricular pacing (using an epicardial left ventricular lead and a RV lead) and intrinsic activation
O
Outcome
Haemodynamic function (LV systolic mechanics, dP/dt(max), max LV pressure, LV relaxation) and electrical activation (QRS and total endocardial activation durations) after 5 min of consistent capturesurrogate

Main Result

p-value: p=<0.05

In an acute swine model with structurally normal hearts, biventricular pacing impairs systolic function and electrical activation, whereas right ventricular septal pacing better preserves intrinsic function.

Cite This Study

Kimmel et al. (2007) studied Structurally normal hearts (n=7). Biventricular pacing and single-site right ventricular pacing vs. Intrinsic activation was evaluated on Haemodynamic function and electrical activation sequences (p=<0.05). Acute biventricular pacing in intact, synchronous swine hearts resulted in systolic dysfunction (P<0.05) and abnormal left ventricular electrical activation compared to intrinsic activation.

synapsesocial.com/papers/6a0edf7625c30b2cc7f9dd42https://doi.org/10.1093/europace/eum218
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