scholarly journals Is left ventricular superior to right ventricular pacing in children with congenital or postoperative complete heart block?

Author(s):  
Ch Bharat Siddharth ◽  
Jay Relan

Summary A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was ‘Is left ventricular superior to right ventricular pacing in children with congenital or postoperative complete heart block?’ Altogether, 19 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Two large multicentric showed that site of pacing was the major determinant of left ventricular (LV) function with LV pacing being superior to RV pacing, though the number of patients paced via LV was lesser in comparison to right ventricular (RV). There were 2 prospective, 2 retrospective and 1 cross-sectional studies with fewer patients that demonstrated superiority of LV over RV pacing in preserving LV function. Only 1 small-scale retrospective study showed similar results of LV and RV pacing on LV function. One cross-sectional study showed superiority of LV apical pacing on exercise tolerance. As per the existing literature, LV apex seems to be the most optimal site for epicardial pacing while RV free wall pacing has the highest risk of causing LV dysfunction over the long term. We conclude that LV pacing appears to be superior to RV pacing in terms of long-term effect on cardiac function and ventricular synchrony.

2019 ◽  
Vol 73 (13) ◽  
pp. 1673-1687 ◽  
Author(s):  
James F. Dawkins ◽  
Yu-Feng Hu ◽  
Jackelyn Valle ◽  
Lizbeth Sanchez ◽  
Yong Zheng ◽  
...  

2009 ◽  
Vol 32 (3) ◽  
pp. 354-362 ◽  
Author(s):  
PANAYOTA FLEVARI ◽  
DIONYSSIOS LEFTHERIOTIS ◽  
KATERINA FOUNTOULAKI ◽  
FOTIS PANOU ◽  
ANGELOS G. RIGOPOULOS ◽  
...  

2006 ◽  
Vol 291 (5) ◽  
pp. H2377-H2379 ◽  
Author(s):  
Abdul Al-Hesayen ◽  
John D. Parker

Right ventricular (RV) pacing is now recognized to play a role in the development of heart failure in patients with and without underlying left ventricular (LV) dysfunction. We used the cardiac norepinephrine spillover method to test the hypothesis that RV pacing is associated with cardiac sympathetic activation. We studied 8 patients with normal LV function using temporary right atrial and ventricular pacing wires. All measurements were carried out during a fixed atrial pacing rate. The radiotracer norepinephrine spillover technique was employed to measure total body and cardiac sympathetic activity while changes in LV performance were evaluated with a high-fidelity manometer catheter. Atrioventricular synchronous RV pacing, compared with atrial pacing alone, was associated with a 65% increase in cardiac norepinephrine spillover, an increase in LV end-diastolic pressure, and a reduction in myocardial efficiency. These responses may play a role in the development of heart failure and poor outcomes that are associated with chronic RV pacing.


2013 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Giovanni Di Salvo ◽  
Ziad Issa ◽  
Waleed Manea ◽  
Ziad Al Bulbul ◽  
Mamdouh Al Ahmadi ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document