PMID- 27670586 OWN - NLM STAT- MEDLINE DCOM- 20170428 LR - 20170428 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 26 IP - 4 DP - 2017 Apr TI - Acute Haemodynamic and Echocardiographic Effects of Multiple Configurations of Left Ventricular Pacing Sites in Acute Myocardial Infarction: Experimental Study. PG - 383-394 LID - S1443-9506(16)31552-9 [pii] LID - 10.1016/j.hlc.2016.07.016 [doi] AB - BACKGROUND: Left ventricular (LV) pacing is unsuccessful in a significant number of patients, mainly due to sub-optimal LV pacing location. Nevertheless, data about the impact of different pacing sites on LV function in ischaemic myocardium are scarce. The purpose of this study was to investigate the effect of combinations of alternative LV pacing sites on LV mechanics after experimental acute anterior myocardial infarction (AMI), in order to define the optimal configuration. METHODS: Atrioventricular epicardial pacing at alternative pacing sites was performed in 16 healthy pigs simultaneously, after experimental AMI. Standard right ventricular (RV) apical pacing was combined with: i) LV apex lateral wall; ii) LV basal posterior wall; iii) LV basal anterior wall, and; iv) LV basal anterior wall + LV basal posterior wall. Moreover the pacing configurations of, v) LV basal posterior wall + LV apex lateral wall; vi) LV basal posterior wall + LV basal anterior wall, and; vii) LV basal anterior wall + LV apex lateral wall were also investigated. Haemodynamic parameters, together with classic and novel echocardiographic indices were used, to evaluate the effect of each pacing combination. A speckle tracking technique using EchoPAC software was used. RESULTS: After AMI, the pacing combination of LV apex lateral wall and LV basal posterior wall had the most favourable effect on LV function, leading to similar haemodynamic and torsional effects with sinus rhythm (all variables p>0.05). CONCLUSIONS: In pig hearts after AMI, the combination of pacing LV apex lateral wall and LV basal posterior wall managed to maintain the LV function at a level comparable to the sinus rhythm. CI - Copyright (c) 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Matthaios, I AU - Matthaios I AD - Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece. Electronic address: giannismat@gmail.com. FAU - Kaladaridou, A AU - Kaladaridou A AD - Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece. FAU - Skaltsiotes, E AU - Skaltsiotes E AD - Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece. FAU - Agrios, J AU - Agrios J AD - Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece. FAU - Antoniou, A AU - Antoniou A AD - Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece. FAU - Georgiopoulos, G AU - Georgiopoulos G AD - Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece. FAU - Papadopoulou, E AU - Papadopoulou E AD - Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece. FAU - Pamboucas, C AU - Pamboucas C AD - Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece. FAU - Toumanidis, S AU - Toumanidis S AD - Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece. LA - eng PT - Journal Article DEP - 20160829 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 SB - IM MH - Animals MH - *Cardiac Pacing, Artificial MH - Heart Ventricles/*physiopathology MH - *Hemodynamics MH - *Models, Cardiovascular MH - *Myocardial Infarction/physiopathology/therapy MH - *Software MH - Swine OTO - NOTNLM OT - Acute myocardial infarction OT - Cardiac mechanics OT - Pacing OT - Torsion EDAT- 2016/09/28 06:00 MHDA- 2017/04/30 06:00 CRDT- 2016/09/28 06:00 PHST- 2016/03/23 00:00 [received] PHST- 2016/07/25 00:00 [revised] PHST- 2016/07/29 00:00 [accepted] PHST- 2016/09/28 06:00 [pubmed] PHST- 2017/04/30 06:00 [medline] PHST- 2016/09/28 06:00 [entrez] AID - S1443-9506(16)31552-9 [pii] AID - 10.1016/j.hlc.2016.07.016 [doi] PST - ppublish SO - Heart Lung Circ. 2017 Apr;26(4):383-394. doi: 10.1016/j.hlc.2016.07.016. Epub 2016 Aug 29.