Financial Disclosure. Conclusions. Me thods. Results. Background. Biventricular Pacing is Not Associated with Proarrythmic Effects in Patients with Left Ventricular Dysfunction.
Biventricular Pacing is Not Associated with Proarrythmic Effects
in Patients with Left Ventricular Dysfunction
Adam S. Budzikowski, MD, PhD, Ofek Y. Hai, DO, Cristina A. Mitre MD, Opesanmi Esan, MD, Ayotunde Bamimore, MD, John Kassotis, MD
SUNY Downstate, Division of Cardiovascular Medicine—EP Section. 450 Clarkson Ave Box 1199, Brooklyn, NY 11203 USA.
Cardiac Resynchronization Therapy (CRT) has emerged as an effective treatment modality in patients with advanced heart failure. CRT significantly improves cardiac output, quality of life, and NYHA functional class. However, little is known about the consequences of reversing the direction of activation of the LV wall.
Multiple case reports and basic science studies seem to suggest that biventricular pacing in patients with severe left ventricular dysfunction may be associated with proarrhythmic effects despite improvement in survival.
Most published studies that attempted to ascertain this issue suffer lack of true control population. To avoid this difficulty, we compared the ventricular arrhythmic burden in patients who underwent an upgrade from single chamber to a biventricular defibrillator.
Our objective was to determine if biventricular pacing in patients with LV dysfunction is associated with change in frequency of ventricular arrhythmias.
Baseline Characteristics (25 patients)
Although there was an improvement in the functional status of the patients, no significant remodeling of the left ventricle was seen. This may account for the absence of change in the burden of ventricular arrhythmias following the upgrade to resynchronization system.
ASB-speakers bureau Zoll, Honoraria Boston Scientific and St. Jude Medical. CM, OE, AB – Fellowship support Medtronic, Boston Scientific, St. Jude Medical. JK – speakers Bureau Medtronic, Zoll.