PMID- 12644010
OWN - NLM
STAT- MEDLINE
DCOM- 20030814
LR  - 20191210
IS  - 1388-9842 (Print)
IS  - 1388-9842 (Linking)
VI  - 5
IP  - 2
DP  - 2003 Mar
TI  - Regional myocardial perfusion during chronic biventricular pacing and after acute 
      change of the pacing mode in patients with congestive heart failure and bundle 
      branch block treated with an atrioventricular sequential biventricular pacemaker.
PG  - 179-86
AB  - BACKGROUND: Biventricular (BiV) pacing has been found to improve systolic 
      function and exercise tolerance in patients with severe congestive heart failure 
      and bundle branch block. The mechanisms behind this beneficial effect is still 
      not sufficiently clarified. AIM: To evaluate the regional myocardial perfusion 
      (MP) during BiV pacing and after acute change of the pacing mode to conventional 
      dual chamber (DDD) pacing, and single chamber atrial (AAI) pacing in patients 
      with severe congestive heart failure and prolonged QRS width treated with chronic 
      BiV pacing. METHODS AND RESULTS: Fourteen patients (age 63+/-7 years, 13 male) 
      were evaluated 13+/-7 months after implantation of a triple-chamber biventricular 
      pacemaker. MP was quantified with 13N-labeled ammonia positron emission 
      tomography during BiV pacing, DDD pacing, and AAI pacing. MP was assessed in the 
      anterior, lateral, inferior, and septal regions, and the global mean MP was 
      calculated. Clinical assessment was performed before pacemaker implantation and 
      after at least 3 months of BiV pacing including a 6-min walk test (WT), New York 
      Heart Association (NYHA) class functional score and echocardiography. Global mean 
      MP (BiV: 0.65+/-0.20 vs. DDD: 0.65+/-0.21 vs. AAI: 0.65+/-0.18 mlg(-1)min(-1)) 
      and MP in each of the four regions did not differ between the three pacing modes. 
      The patients improved clinically during BiV pacing; 6 min WT increased (338+/-59 
      vs. 415+/-73 m, P<0.001), NYHA class score improved (class I/II/III/IV: 0/0/11/3 
      vs. 1/9/2/0, P<0.001), and left ventricular ejection fraction increased (21+/-5 
      vs. 29+/-8%, P=0.004). CONCLUSION: No differences in regional MP are detectable 
      after chronic BiV pacing when the pacing mode is changed acutely in patients with 
      severe congestive heart failure and bundle branch block. This finding indicates, 
      that the clinical improvement caused by BiV pacing is not associated with any 
      increase in the MP and thereby oxygen demand.
FAU - Nielsen, Jens Cosedis
AU  - Nielsen JC
AD  - Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 
      Brendstrupgaardsvej, DK-8200 N, Aarhus, Denmark. cosedis@dadlnet.dk
FAU - Bottcher, Morten
AU  - Bottcher M
FAU - Jensen, Henrik Kjaerulf
AU  - Jensen HK
FAU - Nielsen, Torsten Toftegaard
AU  - Nielsen TT
FAU - Pedersen, Anders Kirstein
AU  - Pedersen AK
FAU - Mortensen, Peter Thomas
AU  - Mortensen PT
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
MH  - Aged
MH  - Bundle-Branch Block/*therapy
MH  - *Cardiac Pacing, Artificial
MH  - Denmark
MH  - Electrocardiography
MH  - Female
MH  - Heart Atria/*physiopathology/*surgery
MH  - Heart Failure/physiopathology/*therapy
MH  - Heart Ventricles/physiopathology/surgery
MH  - Humans
MH  - *Intraoperative Care
MH  - Male
MH  - Middle Aged
MH  - *Myocardial Reperfusion
MH  - *Pacemaker, Artificial
MH  - *Postoperative Care
MH  - Severity of Illness Index
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/physiopathology/therapy
EDAT- 2003/03/20 04:00
MHDA- 2003/08/15 05:00
CRDT- 2003/03/20 04:00
PHST- 2003/03/20 04:00 [pubmed]
PHST- 2003/08/15 05:00 [medline]
PHST- 2003/03/20 04:00 [entrez]
AID - S1388984202002453 [pii]
AID - 10.1016/s1388-9842(02)00245-3 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2003 Mar;5(2):179-86. doi: 10.1016/s1388-9842(02)00245-3.