Closed loop stimulation improves ejection fraction in pediatric patients with pacemaker and ventricular dysfunction

Fabrizio Drago, Massimo S. Silvetti, Antonella De Santis, Giovanni Fazio, Gianluca Biancalana, Giorgia Grutter, Gabriele Rinelli

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The aim of this prospective study was to evaluate the effect of the closed loop stimulation (CLS) on the ejection fraction in pediatric patients, affected by complete atrioventricular block (CAVB) or CAVB and sinus node dysfunction (SND), with a previously implanted pacemaker (PM) and ventricular dysfunction. The role of electrical therapy in the treatment of pediatric patients with congenital atrioventricular (AV) blocks has been shown. Conventional right ventricular pacing seems to affect ventricular function. Up to now, the feasibility and the long-term results of biventricular pacing in pediatric patients were not entirely clear. Methods: In eight pediatric patients with a previously implanted single or dual chamber PM, ventricular dysfunction, and CAVB or SND and CAVB, a dual chamber PM INOS2+-CLS (Biotronik GmbH, Berlin, Germany) was implanted. The effect of the physiological modulation of CLS pacing mode on the ejection fraction was evaluated by Echo-Doppler examination. Measurements were performed before the substitution of the old PM and for up to 2 years of follow-up. Results: All patients showed correct electrical parameters at implantation and during follow-up. The mean value of the ejection fraction measured before the replacement of the old PM was 36 ± 7%, while after 2 years it was 47 ± 1% (P <0.003). No patient showed any worsening of the ejection fraction, while only one showed no improvement. Conclusions: DDD-CLS pacing seems to improve ventricular function in pediatric patients with CAVB and/SND in spite of the use of the apical right conventional stimulation.

Original languageEnglish
Pages (from-to)33-37
Number of pages5
JournalPACE - Pacing and Clinical Electrophysiology
Volume30
Issue number1
DOIs
Publication statusPublished - Jan 2007

Fingerprint

Ventricular Dysfunction
Atrioventricular Block
Pediatrics
Sick Sinus Syndrome
Atrioventricular Node
Ventricular Function
Dichlorodiphenyldichloroethane
Cardiac Resynchronization Therapy
Berlin
Germany
Prospective Studies
Therapeutics

Keywords

  • Pediatric age
  • Physiological pacing
  • Ventricular dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Closed loop stimulation improves ejection fraction in pediatric patients with pacemaker and ventricular dysfunction. / Drago, Fabrizio; Silvetti, Massimo S.; De Santis, Antonella; Fazio, Giovanni; Biancalana, Gianluca; Grutter, Giorgia; Rinelli, Gabriele.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 30, No. 1, 01.2007, p. 33-37.

Research output: Contribution to journalArticle

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N2 - Background: The aim of this prospective study was to evaluate the effect of the closed loop stimulation (CLS) on the ejection fraction in pediatric patients, affected by complete atrioventricular block (CAVB) or CAVB and sinus node dysfunction (SND), with a previously implanted pacemaker (PM) and ventricular dysfunction. The role of electrical therapy in the treatment of pediatric patients with congenital atrioventricular (AV) blocks has been shown. Conventional right ventricular pacing seems to affect ventricular function. Up to now, the feasibility and the long-term results of biventricular pacing in pediatric patients were not entirely clear. Methods: In eight pediatric patients with a previously implanted single or dual chamber PM, ventricular dysfunction, and CAVB or SND and CAVB, a dual chamber PM INOS2+-CLS (Biotronik GmbH, Berlin, Germany) was implanted. The effect of the physiological modulation of CLS pacing mode on the ejection fraction was evaluated by Echo-Doppler examination. Measurements were performed before the substitution of the old PM and for up to 2 years of follow-up. Results: All patients showed correct electrical parameters at implantation and during follow-up. The mean value of the ejection fraction measured before the replacement of the old PM was 36 ± 7%, while after 2 years it was 47 ± 1% (P <0.003). No patient showed any worsening of the ejection fraction, while only one showed no improvement. Conclusions: DDD-CLS pacing seems to improve ventricular function in pediatric patients with CAVB and/SND in spite of the use of the apical right conventional stimulation.

AB - Background: The aim of this prospective study was to evaluate the effect of the closed loop stimulation (CLS) on the ejection fraction in pediatric patients, affected by complete atrioventricular block (CAVB) or CAVB and sinus node dysfunction (SND), with a previously implanted pacemaker (PM) and ventricular dysfunction. The role of electrical therapy in the treatment of pediatric patients with congenital atrioventricular (AV) blocks has been shown. Conventional right ventricular pacing seems to affect ventricular function. Up to now, the feasibility and the long-term results of biventricular pacing in pediatric patients were not entirely clear. Methods: In eight pediatric patients with a previously implanted single or dual chamber PM, ventricular dysfunction, and CAVB or SND and CAVB, a dual chamber PM INOS2+-CLS (Biotronik GmbH, Berlin, Germany) was implanted. The effect of the physiological modulation of CLS pacing mode on the ejection fraction was evaluated by Echo-Doppler examination. Measurements were performed before the substitution of the old PM and for up to 2 years of follow-up. Results: All patients showed correct electrical parameters at implantation and during follow-up. The mean value of the ejection fraction measured before the replacement of the old PM was 36 ± 7%, while after 2 years it was 47 ± 1% (P <0.003). No patient showed any worsening of the ejection fraction, while only one showed no improvement. Conclusions: DDD-CLS pacing seems to improve ventricular function in pediatric patients with CAVB and/SND in spite of the use of the apical right conventional stimulation.

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