Left Ventricular Endocardial Pacing Improves Resynchronization Therapy in Canine Left Bundle-Branch Hearts
BACKGROUND—We investigated the benefits of the more physiological activation achieved by left ventricular (LV) endocardial pacing (ENDO) as compared with conventional epicardial (EPI) LV pacing in cardiac resynchronization therapy. METHODS AND RESULTS—In 8 anesthetized dogs with experimental left bu...
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| Veröffentlicht in: | Circulation. Arrhythmia and electrophysiology 2009-10, Vol.2 (5), p.580-587 |
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| container_title | Circulation. Arrhythmia and electrophysiology |
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| creator | van Deursen, Caroline van Geldorp, Irene E Rademakers, Leonard M van Hunnik, Arne Kuiper, Marion Klersy, Catherine Auricchio, Angelo Prinzen, Frits W |
| description | BACKGROUND—We investigated the benefits of the more physiological activation achieved by left ventricular (LV) endocardial pacing (ENDO) as compared with conventional epicardial (EPI) LV pacing in cardiac resynchronization therapy.
METHODS AND RESULTS—In 8 anesthetized dogs with experimental left bundle-branch block, pacing leads were positioned in the right atrium, right ventricle, and at 8 paired (EPI and ENDO) LV sites. Systolic LV pump function was assessed as LVdP/dtmax and stroke work and diastolic function as LVdP/dtmin. Electrical activation and dispersion of repolarization were determined from 122 epicardial and endocardial electrodes and from analysis of the surface ECG. Overall, ENDO-biventricular (BiV) pacing more than doubled the degree of electrical resynchronization and increased the benefit on LVdP/dtmax and stroke work by 90% and 50%, respectively, as compared with EPI-BiV pacing. During single-site LV pacing, the range of AV intervals with a >10% increase in LV resynchronization (79±31 versus 32±24 ms, P |
| doi_str_mv | 10.1161/CIRCEP.108.846022 |
| format | Article |
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METHODS AND RESULTS—In 8 anesthetized dogs with experimental left bundle-branch block, pacing leads were positioned in the right atrium, right ventricle, and at 8 paired (EPI and ENDO) LV sites. Systolic LV pump function was assessed as LVdP/dtmax and stroke work and diastolic function as LVdP/dtmin. Electrical activation and dispersion of repolarization were determined from 122 epicardial and endocardial electrodes and from analysis of the surface ECG. Overall, ENDO-biventricular (BiV) pacing more than doubled the degree of electrical resynchronization and increased the benefit on LVdP/dtmax and stroke work by 90% and 50%, respectively, as compared with EPI-BiV pacing. During single-site LV pacing, the range of AV intervals with a >10% increase in LV resynchronization (79±31 versus 32±24 ms, P<0.05) and LVdP/dtmax (92±29 versus 63±39 ms) was significantly longer for ENDO than for EPI pacing. EPI-BiV but not ENDO-BiV pacing created a significant (40±21 ms) transmural dispersion of repolarization.
CONCLUSIONS—Data from this acute animal study indicate that the use of an endocardial LV pacing electrode may increase the efficacy of resynchronization therapy as compared with conventional epicardial resynchronization therapy.</description><identifier>ISSN: 1941-3149</identifier><identifier>EISSN: 1941-3084</identifier><identifier>DOI: 10.1161/CIRCEP.108.846022</identifier><identifier>PMID: 19843927</identifier><language>eng</language><publisher>Hagerstown, MD: American Heart Association, Inc</publisher><subject>Animals ; Biological and medical sciences ; Bundle-Branch Block - physiopathology ; Bundle-Branch Block - therapy ; Cardiac Catheterization ; Cardiac dysrhythmias ; Cardiac Pacing, Artificial - methods ; Cardiology. Vascular system ; Dogs ; Electrocardiography ; Heart ; Hemodynamics - physiology ; Medical sciences ; Models, Animal ; Models, Cardiovascular ; Neurology ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Vascular diseases and vascular malformations of the nervous system ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Dysfunction, Left - therapy</subject><ispartof>Circulation. Arrhythmia and electrophysiology, 2009-10, Vol.2 (5), p.580-587</ispartof><rights>2009 American Heart Association, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5155-789a79778c99d3a48b01fa42a6ea95cf0cce535b6598f4f80ec91a17e4676a943</citedby><cites>FETCH-LOGICAL-c5155-789a79778c99d3a48b01fa42a6ea95cf0cce535b6598f4f80ec91a17e4676a943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,3674,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22283772$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19843927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Deursen, Caroline</creatorcontrib><creatorcontrib>van Geldorp, Irene E</creatorcontrib><creatorcontrib>Rademakers, Leonard M</creatorcontrib><creatorcontrib>van Hunnik, Arne</creatorcontrib><creatorcontrib>Kuiper, Marion</creatorcontrib><creatorcontrib>Klersy, Catherine</creatorcontrib><creatorcontrib>Auricchio, Angelo</creatorcontrib><creatorcontrib>Prinzen, Frits W</creatorcontrib><title>Left Ventricular Endocardial Pacing Improves Resynchronization Therapy in Canine Left Bundle-Branch Hearts</title><title>Circulation. Arrhythmia and electrophysiology</title><addtitle>Circ Arrhythm Electrophysiol</addtitle><description>BACKGROUND—We investigated the benefits of the more physiological activation achieved by left ventricular (LV) endocardial pacing (ENDO) as compared with conventional epicardial (EPI) LV pacing in cardiac resynchronization therapy.
METHODS AND RESULTS—In 8 anesthetized dogs with experimental left bundle-branch block, pacing leads were positioned in the right atrium, right ventricle, and at 8 paired (EPI and ENDO) LV sites. Systolic LV pump function was assessed as LVdP/dtmax and stroke work and diastolic function as LVdP/dtmin. Electrical activation and dispersion of repolarization were determined from 122 epicardial and endocardial electrodes and from analysis of the surface ECG. Overall, ENDO-biventricular (BiV) pacing more than doubled the degree of electrical resynchronization and increased the benefit on LVdP/dtmax and stroke work by 90% and 50%, respectively, as compared with EPI-BiV pacing. During single-site LV pacing, the range of AV intervals with a >10% increase in LV resynchronization (79±31 versus 32±24 ms, P<0.05) and LVdP/dtmax (92±29 versus 63±39 ms) was significantly longer for ENDO than for EPI pacing. EPI-BiV but not ENDO-BiV pacing created a significant (40±21 ms) transmural dispersion of repolarization.
CONCLUSIONS—Data from this acute animal study indicate that the use of an endocardial LV pacing electrode may increase the efficacy of resynchronization therapy as compared with conventional epicardial resynchronization therapy.</description><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Bundle-Branch Block - physiopathology</subject><subject>Bundle-Branch Block - therapy</subject><subject>Cardiac Catheterization</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiac Pacing, Artificial - methods</subject><subject>Cardiology. Vascular system</subject><subject>Dogs</subject><subject>Electrocardiography</subject><subject>Heart</subject><subject>Hemodynamics - physiology</subject><subject>Medical sciences</subject><subject>Models, Animal</subject><subject>Models, Cardiovascular</subject><subject>Neurology</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Dysfunction, Left - therapy</subject><issn>1941-3149</issn><issn>1941-3084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkFFv0zAQxyPExMbGB-AF-QXxlOKLndh-ZFFhlSoxTdteo6tzoR6uU-yEqXx6UlLA0sk-6Xf_s35Z9hb4AqCCj_Xqrl7eLoDrhZYVL4oX2QUYCbngWr78-wZpzrPXKT1xXoGG6lV2DkZLYQp1kT2tqRvYI4UhOjt6jGwZ2t5ibB16dovWhW9stdvH_icldkfpEOw29sH9wsH1gd1vKeL-wFxgNQYXiP0JvB5D6ym_jjjh7IYwDukqO-vQJ3pzui-zh8_L-_omX3_9sqo_rXNbQlnmShtURiltjWkFSr3h0KEssCI0pe24tVSKclOVRney05ysAQRFslIVGikusw9z7vTpHyOlodm5ZMl7DNSPqVFCclOJQk8kzKSNfUqRumYf3Q7joQHeHA03s-Gp1c1seJp5d0ofNztq_0-clE7A-xOAyaLvjgpc-scVxbRYqWOQnLnn3g8U03c_PlNstoR-2DYchFDSiLzg3ACfTj4VlOI3zNGUBA</recordid><startdate>200910</startdate><enddate>200910</enddate><creator>van Deursen, Caroline</creator><creator>van Geldorp, Irene E</creator><creator>Rademakers, Leonard M</creator><creator>van Hunnik, Arne</creator><creator>Kuiper, Marion</creator><creator>Klersy, Catherine</creator><creator>Auricchio, Angelo</creator><creator>Prinzen, Frits W</creator><general>American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200910</creationdate><title>Left Ventricular Endocardial Pacing Improves Resynchronization Therapy in Canine Left Bundle-Branch Hearts</title><author>van Deursen, Caroline ; van Geldorp, Irene E ; Rademakers, Leonard M ; van Hunnik, Arne ; Kuiper, Marion ; Klersy, Catherine ; Auricchio, Angelo ; Prinzen, Frits W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5155-789a79778c99d3a48b01fa42a6ea95cf0cce535b6598f4f80ec91a17e4676a943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Bundle-Branch Block - physiopathology</topic><topic>Bundle-Branch Block - therapy</topic><topic>Cardiac Catheterization</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiac Pacing, Artificial - methods</topic><topic>Cardiology. Vascular system</topic><topic>Dogs</topic><topic>Electrocardiography</topic><topic>Heart</topic><topic>Hemodynamics - physiology</topic><topic>Medical sciences</topic><topic>Models, Animal</topic><topic>Models, Cardiovascular</topic><topic>Neurology</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>Ventricular Dysfunction, Left - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Deursen, Caroline</creatorcontrib><creatorcontrib>van Geldorp, Irene E</creatorcontrib><creatorcontrib>Rademakers, Leonard M</creatorcontrib><creatorcontrib>van Hunnik, Arne</creatorcontrib><creatorcontrib>Kuiper, Marion</creatorcontrib><creatorcontrib>Klersy, Catherine</creatorcontrib><creatorcontrib>Auricchio, Angelo</creatorcontrib><creatorcontrib>Prinzen, Frits W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Deursen, Caroline</au><au>van Geldorp, Irene E</au><au>Rademakers, Leonard M</au><au>van Hunnik, Arne</au><au>Kuiper, Marion</au><au>Klersy, Catherine</au><au>Auricchio, Angelo</au><au>Prinzen, Frits W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left Ventricular Endocardial Pacing Improves Resynchronization Therapy in Canine Left Bundle-Branch Hearts</atitle><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle><addtitle>Circ Arrhythm Electrophysiol</addtitle><date>2009-10</date><risdate>2009</risdate><volume>2</volume><issue>5</issue><spage>580</spage><epage>587</epage><pages>580-587</pages><issn>1941-3149</issn><eissn>1941-3084</eissn><abstract>BACKGROUND—We investigated the benefits of the more physiological activation achieved by left ventricular (LV) endocardial pacing (ENDO) as compared with conventional epicardial (EPI) LV pacing in cardiac resynchronization therapy.
METHODS AND RESULTS—In 8 anesthetized dogs with experimental left bundle-branch block, pacing leads were positioned in the right atrium, right ventricle, and at 8 paired (EPI and ENDO) LV sites. Systolic LV pump function was assessed as LVdP/dtmax and stroke work and diastolic function as LVdP/dtmin. Electrical activation and dispersion of repolarization were determined from 122 epicardial and endocardial electrodes and from analysis of the surface ECG. Overall, ENDO-biventricular (BiV) pacing more than doubled the degree of electrical resynchronization and increased the benefit on LVdP/dtmax and stroke work by 90% and 50%, respectively, as compared with EPI-BiV pacing. During single-site LV pacing, the range of AV intervals with a >10% increase in LV resynchronization (79±31 versus 32±24 ms, P<0.05) and LVdP/dtmax (92±29 versus 63±39 ms) was significantly longer for ENDO than for EPI pacing. EPI-BiV but not ENDO-BiV pacing created a significant (40±21 ms) transmural dispersion of repolarization.
CONCLUSIONS—Data from this acute animal study indicate that the use of an endocardial LV pacing electrode may increase the efficacy of resynchronization therapy as compared with conventional epicardial resynchronization therapy.</abstract><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>19843927</pmid><doi>10.1161/CIRCEP.108.846022</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Animals Biological and medical sciences Bundle-Branch Block - physiopathology Bundle-Branch Block - therapy Cardiac Catheterization Cardiac dysrhythmias Cardiac Pacing, Artificial - methods Cardiology. Vascular system Dogs Electrocardiography Heart Hemodynamics - physiology Medical sciences Models, Animal Models, Cardiovascular Neurology Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Vascular diseases and vascular malformations of the nervous system Ventricular Dysfunction, Left - physiopathology Ventricular Dysfunction, Left - therapy |
| title | Left Ventricular Endocardial Pacing Improves Resynchronization Therapy in Canine Left Bundle-Branch Hearts |
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