title: Advantage of right ventricular outflow tract pacing on cardiac function and coronary circulation in comparison with right ventricular apex pacing.
abstract: BACKGROUND
  The purpose of this study was to investigate the acute effect of right ventricular outflow tract (RVOT) pacing and right ventricular apex (RVA) pacing on synchronous ventricular activation and coronary flow dynamics.
  
  
  METHODS
  We enrolled 20 consecutive patients who underwent electrophysiologic study. Echocardiographic study including two-dimensional tissue tracking imaging and Doppler guide wire examination was performed during RVOT pacing and RVA pacing.
  
  
  RESULTS
  The improvement of left ventricular radial dyssynchrony (99 ± 12 ms vs. 142 ± 16 ms, P < .001), time-averaged peak velocities of coronary blood flow (54 ± 18 cm/s vs. 47 ± 17 cm/s, P = .007), and coronary microvascular resistance index (2.0 ± 0.8 vs. 2.4 ± 1.1, P = .028) was observed with RVOT pacing compared with RVA pacing.
  
  
  CONCLUSIONS
  RVOT pacing might provide favorable effects on the left ventricular function and coronary flow dynamics over RVA pacing.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan. akasat@wakayama-med.ac.jp
authors.forename: Takahshi
authors.initials: T
authors.lastname: Yamano
authors.forename: Takashi
authors.initials: T
authors.lastname: Kubo
authors.forename: Shigeho
authors.initials: S
authors.lastname: Takarada
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Komukai
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ino
authors.forename: Hironori
authors.initials: H
authors.lastname: Kitabata
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hirata
authors.forename: Atushi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Toshio
authors.initials: T
authors.lastname: Imanishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D015331:Cohort Studies; D003326:Coronary Circulation / Q000502:physiology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D010138:Pacemaker, Artificial; D018570:Risk Assessment; D013318:Stroke Volume; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000628:therapy*; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D020257:Ventricular Remodeling / Q000502:physiology