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Right ventricle pacing tricuspid valve and ventricular function

Siva K Mulpuru, Yong-Mei Cha, Samuel J Asirvatham
Right ventricular apical pacing is associated with an increased incidence of heart failure, atrial fibrillation, and overall mortality. As a result, pacing the ventricles in a manner that closely mimics normal AV conduction with an intact His-Purkinje system has been explored. Recently, the sustainable benefits of selective His-bundle stimulation have been demonstrated and proposed as the preferred method of ventricular stimulation for appropriate patients. Ideally, conduction system pacing should be selective without myocardial capture, overcome distal bundle branch block when present, and not compromise tricuspid valve function...
November 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Makoto Saito, Andrea Iannaccone, Gerry Kaye, Kazuaki Negishi, Wojciech Kosmala, Thomas H Marwick
Right ventricular (RV) pacing has been linked with lead-induced tricuspid regurgitation (TR), left ventricular (LV) dysfunction, and dyssynchrony, but the effect of pacing on RV function is unclear. We sought to investigate the effect of pacing on RV synchrony, RV function, and TR, and their association with LV function. In this substudy of the PROTECT-PACE (Protection of left ventricular function during right ventricular pacing) study of the effects of RV pacing in patients with preserved ejection fraction, 145 patients (76 RV apex and 69 non-RV apex pacing) had measurable RV parameters...
December 15, 2015: American Journal of Cardiology
Tomas Konecny, Christopher V DeSimone, Paul A Friedman, Charles Bruce, Samuel J Asirvatham
Ventricular pacing is most commonly performed at the right ventricular (RV) apex. This is not without risk as placement requires crossing the tricuspid valve (TV) and may cause valvular dysfunction and dyssynchronous activation of the ventricles. The fact that the tricuspid valve lies more apically than the mitral valve allows for the possibility of pacing the ventricles from the right atrium (RA) via the "atrio-ventricular septum" without crossing the TV or entering the coronary sinus (CS). In order to mitigate far field activation inherent to current pacing technology, we constructed a novel lead in which the cathode and anode are both intra-myocardial...
May 2013: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Luca Donazzan, Giovanni Stellin, Werner Guenther Rauhe, Lucio Bonazza, Josef Stuefer, Cristina Romeo, Roberto Crepaz
Late dysfunction of the systemic right ventricle in patients with complete transposition of the great arteries after Mustard or Senning procedures and progressive deterioration of the clinical status has been demonstrated. However, evidence-based data on the effective therapy for systemic right ventricular dysfunction in these patients are yet to be defined. Our patient shows an improvement in the right ventricular systolic function, with a reduction in tricuspid regurgitation and a consequent better exercise tolerance after a hybrid approach consisting of an upgrading of a previous transvenous-implanted dual-chamber Implantable Cardiac Defibrillator to biventricular pacing associated with pulmonary artery banding via an anterior thoracotomy...
February 2014: Cardiology in the Young
Hong Xiang Zhang, Jun Qian, Fa Qin Hou, Yong Ning Liu, Jian Hua Mao
BACKGROUND: Whether right ventricular outfow tract septum (RVOTS) pacing is superior to right ventricular apex (RVA) pacing with respect to left ventricular synchrony, cardiac function, and remodelling in the elderly with normal left ventricular ejection fraction (LVEF), is still unknown. AIM: To assess the impact of RVOTS vs. RVA pacing on the cardiac performance of the elderly with normal LVEF during a long-term observation. METHODS: From 2007 to 2010, 65 patients with standard pacing indications for permanent pacing were recruited and randomised to receive RVA (32 patients) or RVOTS pacing (33 patients)...
2012: Kardiologia Polska
Pornwalee Porapakkham, Pramote Porapakkham, Jarin Assavahanrit, Boonchai Kijsanayotin, Keith Wing Shing
BACKGROUND: The benefits of right ventricular pacing in patients with symptomatic bradycardia are well recognized. Currently, left ventricular (LV) function after cardiac pacing has already been extensively investigated. However existing data on right ventricular (RV) function in these patients is extremely limited. MATERIAL AND METHOD: To test this, records of RV and tricuspid valve function of patients with a pacemaker measured at least a year after implantation were reviewed for a prevalence of RV dysfunction...
August 2012: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Suraj Kapa, Charles J Bruce, Paul A Friedman, Samuel J Asirvatham
While for decades right ventricular (RV) apical pacing has been the standard of care for patients requiring pacemaker or defibrillator lead placement, investigators have sought alternatives to achieve more physiologic electrical activation of the heart and reduce long-term pathologic effects of nonphysiologic apical pacing. These investigations have included attempts at identifying superior pacing sites within the right atrium and RV and development of new leads to enhance specificity of sensing and capture...
December 2010: Cardiovascular Therapeutics
Ahmet Al Fagih, Khaled Al Najashi, Khaled Dagriri, Abdulmajeed Al Otay, Saleh Ahmed Al Ghamdi
We describe a case with pacemaker implantation for cardiac resynchronization therapy (CRT) in a patient with complex congenital heart disease, facilitated by cardiac computed tomography (CT) and coronary sinus (CS) venography. A 37-year-old male presented with congenitally corrected transposition of the great arteries and mesocardia, along with a history of two open heart surgeries (closure of atrial septal defects and a ventricular septal defect, and pulmonary valvectomy at age 7; mechanical tricuspid valve replacement at age 13)...
March 2010: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Mordehay Vaturi, Jairo Kusniec, Yaron Shapira, Roman Nevzorov, Idit Yedidya, Daniel Weisenberg, Daniel Monakier, Boris Strasberg, Alexander Sagie
AIMS: The effect of right ventricular (RV) pacing on tricuspid regurgitation (TR) is debatable and is presumed to be related to an interference with valve closure by the electrode. The aim of the study was to determine the impact of pacing per se on TR grade. METHODS AND RESULTS: The study group included 23 clinically stable patients (13 males; mean age 78 +/- 12 years) with a permanent pacemaker at the RV apex (83% DDD mode) and normal left ventricular function...
July 2010: European Journal of Echocardiography
J Ernesto Molina, Connie L Roberts, David G Benditt
Patients undergoing tricuspid valve replacement who already have a transvenous pacemaker system in the right ventricle are often recommended to have the ventricular lead removed and an epicardial system implanted. However, as a rule, the reliability of endocardial transvenous pacemaker leads has been superior to epicardial systems. Therefore, if the pacemaker lead in the ventricle is still performing well, it may be preferable to leave it in place. In this communication, we present the long-term follow-up results leaving the pacer lead in place by securing it in a position outside the prosthetic valve without interfering with the function of the prosthetic valve...
January 2010: Annals of Thoracic Surgery
Mayurkumar Bhakta, Chedozie C Obioha, Dan Sorajja, Komadoor Srivathsan, Francisco A Arabia, Patrick A Devaleria, Dawn E Jaroszewski, Luis R Scott, Gregory T Altemose
BACKGROUND: Conventional transvenous approaches for implantable cardioverter defibrillator (ICD) lead placement are not possible in some patients with limited venous access or severe tricuspid valve dysfunction. METHODS: We retrospectively identified six patients who underwent ICD placement or revision requiring nontraditional alternative surgical lead placement at our institution between November 2006 and August 2008. The baseline and operative patient characteristic data were accumulated and reviewed...
February 2010: Pacing and Clinical Electrophysiology: PACE
Victor Bautista-Hernandez, Gerald R Marx, Kimberlee Gauvreau, John E Mayer, Frank Cecchin, Pedro J del Nido
BACKGROUND: Early results for anatomic repair of congenitally corrected transposition of the great arteries are excellent with respect to right ventricular and tricuspid valve function. However, development of left ventricular (systemic ventricle) dysfunction late after repair remains a concern. In this study we sought to determine factors leading to late impairment in left ventricular performance. METHODS: From August 1992 to July 2005, 44 patients (median age at surgery, 1...
December 2006: Annals of Thoracic Surgery
Ewa Lewicka-Nowak, Alicja Dabrowska-Kugacka, Sebastian Tybura, Elzbieta Krzymińska-Stasiuk, Rajmund Wilczek, Justyna Staniewicz, Grazyna Swiatecka, Grzegorz Raczek
INTRODUCTION: In patients treated with permanent pacing, the electrode is typically placed in the right ventricular apex (RVA). Published data indicate that such electrode placement leads to an unfavourable ventricular depolarization pattern, while right ventricular outflow tract (RVOT) pacing seems to be more physiological. AIM: To compare long-term effects of RVOT versus RVA pacing on clinical status, left ventricular (LV) function, and the degree of atrioventricular valve regurgitation...
October 2006: Kardiologia Polska
Ioannis H Styliadis, Christodoulos E Papadopoulos, Nikolaos I Gouzoumas, Georgios Giannakoulas, Haralambos I Karvounis, Mihail Karamouzis, Amalia Boufidou, Georgios E Parharidis
OBJECTIVE: To evaluate both left ventricular (LV) and right ventricular (RV) diastolic performance adaptation to variable atrioventricular interval (AVI), in patients with DDD pacing for complete heart block and to investigate a possible interaction between LV and RV in this specific cohort of patients. METHODS: We studied 22 consecutive patients (mean age 65.2 +/- 14.3 years) who underwent DDD pacemaker implantation following admission for complete heart block...
September 2006: Anadolu Kardiyoloji Dergisi: AKD, the Anatolian Journal of Cardiology
Rakesh K Pai, Anita Kedia, Pamela Y F Hsu, Joanna Holmes, Rosella Nawman, M Beth Goens, Fred M Kusumoto
Ebstein's anomaly is a rare congenital heart defect. Patients with severe symptomatic tricuspid regurgitation requiring surgical correction often have conduction system disease. We present a case of a 14 year-old girl with Ebstein's malformation and bioprosthetic tricuspid valve who required permanent pacing for symptomatic bradycardia. The placement of the right ventricular pacing lead was facilitated by the use of the Doppler pulmonary artery velocity time integral as a surrogate for stroke volume. This case demonstrates the importance of site-specific pacing and the utility of Doppler echocardiography to optimize lead placement and cardiac performance in patients with Ebstein's anomaly and advanced conduction system disease...
August 2004: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Hiroyuki Tanaka, Kaoru Okishige, Tomohiro Mizuno, Kazuyuki Kuriu, Fusahiko Itoh, Masato Shimizu, Hideki Akamatsu, Noriyuki Tabuchi, Hirokuni Arai, Makoto Sunamori
OBJECTIVES: Biventricular pacing (BVP) is a new strategy for treating patients with severe congestive heart failure (CHF) and intraventricular conduction delay, but its full potential and technicalities of BVP require further evaluation. We evaluated BVP benefits in 4 patients in whom we implanted a left ventricular lead during primary cardiac surgery. METHODS: Four CHF patients treated surgically between October 2000 and August 2001 underwent, at primary surgery, the implantation of leads in the right atrium, right ventricle, and left ventricle (LV) for postsurgical BVP...
July 2002: Japanese Journal of Thoracic and Cardiovascular Surgery
W Krupa, D Kozłowski, P Derejko, G Swiatecka
Implantation of transvenous devices is a widespread procedure in clinical cardiology. It is well known that the presence of the electrodes in the cardiovascular system can induce fibrosis or fibrous adhesions between them and cause tricuspid regurgitation. Moreover there are suggestions that the placement of the electrode in the tricuspid orifice may also play a role in the development of tricuspid insufficiency because of the thickening of reactive leaflets and the impairment of their mobility in morphological studies...
November 2001: Folia Morphologica (Warsz)
K Morita, H Kurosawa, K Nomura, Y Ko, M Hanai, N Kawada, Y Matsumura, T Inoue
OBJECTIVES: We conducted an acute experimental study to test the feasibility of dynamic cardiomyoplasty in a setting of modified Fontan procedure for univentricular heart with pulmonary hypertension to obtain a possible proxy for high-risk Fontan candidates. METHODS: After electrical preconditioning of the left latissimuss dorsi for 6 weeks in 8 dogs, the right ventricular cavity was totally obliterated with concomittent closure of the tricuspid valve and right pulmonary artery...
April 2001: Japanese Journal of Thoracic and Cardiovascular Surgery
Y Kikuchi, H Shiraishi, H Igarashi, M Yanagisawa
A preliminary experimental study in dogs was conducted to evaluate the feasibility of transvenous cardiac pacing in the fetus with complete heart block associated with hydrops. Four young mongrel dogs were anesthetized with intravenous administration of sodium pentobarbital and mechanically ventilated, and a pacing lead was inserted via the tricuspid valve. The right ventricular cardiac output, aortic pressure and central venous pressure were measured, and the tricuspid valve regurgitation was measured semi-quantitatively using echo-Doppler color flow imaging...
February 1996: Acta Paediatrica Japonica; Overseas Edition
P Mabo, B J Scherlag, A Munsif, K Otomo, R Lazzara
His-bundle electrograms recorded from intracardiac electrode catheters have been a mainstay of basic and clinical electrophysiology. However, consistent His-bundle pacing has not been as readily achieved. In 13 dogs anesthetized with sodium pentobarbital (30 mg/kg), we recorded leads II and aVR as well as the His-bundle electrogram from the aortic root. A deflectable tip multipolar catheter (4 rings, 5 mm apart) was introduced via the right jugular vein into the right ventricle (RV). In 7 dogs, using fluoroscopy, the tip was placed under the tricuspid septal leaflet...
October 1995: Pacing and Clinical Electrophysiology: PACE
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