Comparison of the Acute Hemodynamic Effect of Right Ventricular Apex, Outflow Tract, and Dual-Site Right Ventricular Pacing

• Published in: Annals of noninvasive electrocardiology 2010-10, Vol.15 (4), p.353-359
• Main Authors: Rubaj, Andrzej, Rucinski, Piotr, Sodolski, Tomasz, Bilan, Andrzej, Gulaj, Marcin, Dabrowska-Kugacka, Alicja, Kutarski, Andrzej
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Analysis of Variance; Atrioventricular Block - therapy; Blood Pressure; Cardiac Pacing, Artificial - methods; Cardiac Resynchronization Therapy Devices; Cardiography, Impedance - methods; dual-site right ventricular pacing; Female; heart failure; Humans; impedance cardiography; Male; Middle Aged; Original; Pacemaker, Artificial; right ventricular outflow tract pacing; Ventricular Dysfunction, Left; Ventricular Function, Right
• ISSN: 1082-720X; 1542-474X
• DOI: 10.1111/j.1542-474X.2010.00391.x

Background: We studied the acute effect of pacing at the right ventricular outflow tract (RVOT), right ventricular apex (RVA) and simultaneous RVA and RVOT—dual‐site right ventricular pacing (DuRV) in random order on systolic function using impedance cardiography. Methods: Seventy‐three patients (46 males), aged 52–89 years (mean 71.4 years) subjected to routine dual chamber pacemaker implantation with symptomatic chronic II or atrioventricular block, were included to the study. Results: DuRV pacing resulted in significantly higher cardiac index (CI) in comparison to RVOT and RVA and CI at RVOT was higher than at RVA pacing (2.46 vs 2.35 vs 2.28; P < 0.001). In patients with ejection fraction >50% significantly higher CI was observed during DuRV pacing when compared to RVOT and RVA pacing and there was no difference of CI between RVOT and RVA pacing (2.53 vs 2.41 vs 2.37; P < 0.001). In patients with ejection fraction