Ventricular Pacing Lead Location Alters Systemic Hemodynamics and Left Ventricular Function in Patients With and Without Reduced Ejection Fraction

Randy Lieberman, Luigi Padeletti, Jan Schreuder, Kenneth Jackson, Antonio Michelucci, Andrea Colella, William Eastman, Sergio Valsecchi, Douglas A. Hettrick

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: We compared left ventricular (LV) systolic and diastolic function during right ventricular (RV), LV, and biventricular (BiV) pacing in patients with narrow QRS duration with and without LV dysfunction. Background: The optimal RV pacing lead location for patients with a standard indication for ventricular pacing remains controversial. Methods: Left ventricular pressure and volume data were determined via conductance catheter during electrophysiology study in 31 patients divided into groups with ejection fraction (EF) ≥40% (n = 17) or EF MAX in patients with LV dysfunction. Left ventricular and BiV pacing enhanced an index of global LV cycle efficiency in patients with depressed EF. The detrimental hemodynamic effects of RV pacing were attenuated by selecting the optimal RV pacing site. Conclusions: Right ventricular pacing worsens LV function in patients with and without LV dysfunction unless the RV pacing site is optimized. Left ventricular and BiV pacing preserve LV function in patients with EF >40% and improve function in patients with EF

Original languageEnglish
Pages (from-to)1634-1641
Number of pages8
JournalJournal of the American College of Cardiology
Volume48
Issue number8
DOIs
Publication statusPublished - Oct 17 2006

ASJC Scopus subject areas

  • Nursing(all)

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