Biventricular Pacing in Patients with Bradycardia and Normal Ejection Fraction

In this comparative-effectiveness trial, biventricular pacing prevented the reduction in left ventricular ejection fraction that is seen with right ventricular pacing. The deleterious effect of nonphysiologic right ventricular apical pacing on left ventricular systolic function has been recognized s...

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Veröffentlicht in:The New England journal of medicine 2009-11, Vol.361 (22), p.2123-2134
Hauptverfasser: Yu, Cheuk-Man, Chan, Hamish Chi-Kin, Chan, Joseph Yat-Sun, Zhang, Qing, Omar, Razali, Yip, Gabriel Wai-Kwok, Hussin, Azlan, Fang, Fang, Lam, Kai Huat, Fung, Jeffrey Wing-Hong
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container_end_page 2134
container_issue 22
container_start_page 2123
container_title The New England journal of medicine
container_volume 361
creator Yu, Cheuk-Man
Chan, Hamish Chi-Kin
Chan, Joseph Yat-Sun
Zhang, Qing
Omar, Razali
Yip, Gabriel Wai-Kwok
Hussin, Azlan
Fang, Fang
Lam, Kai Huat
Fung, Jeffrey Wing-Hong
description In this comparative-effectiveness trial, biventricular pacing prevented the reduction in left ventricular ejection fraction that is seen with right ventricular pacing. The deleterious effect of nonphysiologic right ventricular apical pacing on left ventricular systolic function has been recognized since the 1920s. 1 In the Dual Chamber and VVI Implantable Defibrillator (DAVID) trial, the unexpected increased rates of death and hospital admission for heart failure among patients who were randomly assigned to the dual-chamber, rate-adaptive (DDDR) mode were purportedly due to the adverse effect of right ventricular apical pacing on left ventricular structural remodeling. 2 Results of subsequent trials have supported the notion that right ventricular apical pacing might lead to adverse clinical outcomes in patients with standard pacing indications. 3 – 7 Nevertheless, right ventricular . . .
doi_str_mv 10.1056/NEJMoa0907555
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subjects Acute coronary syndromes
Aged
Atrioventricular Block - complications
Beta blockers
Biological and medical sciences
Bradycardia - etiology
Bradycardia - physiopathology
Bradycardia - therapy
Cardiac arrhythmia
Cardiac dysrhythmias
Cardiac Pacing, Artificial - adverse effects
Cardiac Pacing, Artificial - methods
Cardiac Volume
Cardiology
Cardiology. Vascular system
Cardiovascular system
Double-Blind Method
Echocardiography, Three-Dimensional
Female
General aspects
Heart
Heart attacks
Humans
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Pacemaker, Artificial
Prospective Studies
Quality of Life
Sick Sinus Syndrome - complications
Stroke Volume
Ventricular Dysfunction, Left - etiology
Ventricular Dysfunction, Left - prevention & control
Ventricular Dysfunction, Left - therapy
Ventricular Function, Left
Ventricular Remodeling
title Biventricular Pacing in Patients with Bradycardia and Normal Ejection Fraction
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