Right Ventricular Apical Pacing Impairs Left Ventricular Twist as Well as Synchrony: Acute Effects of Right Ventricular Apical Pacing

作者：Matsuoka Ken^*; Nishino Masami; Kato Hiroyasu; Egami Yasuyuki; Shutta Ryu; Yamaguchi Hitoshi; Tanaka Kenjiro; Tanouchi Jun; Yamada Yoshio

来源：Journal of the American Society of Echocardiography, 2009, 22(8): 914-919.

DOI：10.1016/j.echo.2009.05.001

• Right ventricular apical pacing
• Left ventricular twist
• Left ventricular dyssynchrony

Background: This study was designed to compare the rotation of the left ventricular (LV) apex and base, LV synchrony between LV apical and basal rotation, and LV twist, changing from intrinsic atrioventricular conduction to right ventricular apical (RVA) pacing.
Methods: Thirty consecutive patients with sick sinus syndrome who had undergone DDD pacemaker implantation were studied. Changing from intrinsic atrioventricular conduction to RVA pacing, the acute effect on echocardiographic parameters, including LV rotation and twist and LV apical-basal rotation delay, was assessed.
Results: During RVA pacing, values of peak rotation in the LV apex and base and LV twist were significantly lower than during intrinsic atrioventricular conduction (P = .007, P = .003, and P < .0001, respectively). Apical-basal rotation delay during RVA pacing was significantly longer than during intrinsic atrioventricular conduction(P =. 02).
Conclusions: RVA pacing decreases apical and basal LV rotation and induces LV apical-basal rotation delay, resulting in impairment of LV twist. (J Am Soc Echocardiogr 2009; 22: 914-9.)

• 出版日期2009-8