Advantage of right ventricular outflow tract pacing on cardiac function and coronary circulation in comparison with right ventricular apex pacing.
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.
Yamano
Takahshi
T
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan. akasat@wakayama-med.ac.jp
Kubo
Takashi
T
Takarada
Shigeho
S
Ishibashi
Kohei
K
Komukai
Kenichi
K
Tanimoto
Takashi
T
Ino
Yasushi
Y
Kitabata
Hironori
H
Hirata
Kumiko
K
Tanaka
Atushi
A
Imanishi
Toshio
T
Akasaka
Takashi
T
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