Potential Benefit of Bachmann’s Bundle Pacing on Left Ventricular Performance in Patients With Cardiac Resynchronized Therapy

• Suzuki Tomoyuki

  Division of Arrhythmia and Electrophysiology, Shizuoka Saiseikai General Hospital Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University

• Osaka Toshiyuki

  Division of Arrhythmia and Electrophysiology, Shizuoka Saiseikai General Hospital

• Kuroda Yusuke

  Division of Arrhythmia and Electrophysiology, Shizuoka Saiseikai General Hospital

• Hasebe Hideyuki

  Division of Arrhythmia and Electrophysiology, Shizuoka Saiseikai General Hospital

• Yokoyama Eriko

  Division of Arrhythmia and Electrophysiology, Shizuoka Saiseikai General Hospital

• Kamiya Kaichiro

  Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University

• Kodama Itsuo

  Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University

書誌事項

タイトル別名

• Potential Benefit of Bachmann’s Bundle Pacing on Left Ventricular Performance in Patients With Cardiac Resynchronized Therapy

抄録

Background: Right atrial (RA) appendage (RAA) pacing is reported to impair hemodynamic benefits of cardiac resynchronization therapy (CRT) through a considerable delay of left atrial (LA) contraction, which compromises appropriate balance of atrioventricular (AV) and left ventricular (LV) synchrony. Potential usefulness of Bachmann’s bundle (BB) pacing to solve the problem remains to be confirmed. Methods and Results: Atrial synchrony and LV performance was investigated by echocardiography in 25 patients undergoing pacemaker implantation with preserved AV conduction and LV function (Group I), and 15 patients receiving CRT (Group II). In Group I, RAA pacing (AAI mode, n=10) increased P-wave duration (PWD) and RA-to-LA contraction delay (IAMD) compared with sinus rhythm (132±14 and 35±12ms vs. 108±16 and 13±13ms, P<0.001). The delayed LA contraction was associated with early interruption of LV filling, leading to an impairment of LV performance (Tei index: 0.43±0.12 vs. 0.34±0.09, P<0.01). BB pacing (AAI, n=15) did not cause such undesirable effects. In Group II, RA (BB)-paced biventricular pacing (DDD) reduced PWD and IAMD compared with RA-sensed biventricular pacing (VDD) (102±14 and –3±13ms vs. 117±10 and 21±18ms, P<0.001). This restoration of atrial synchrony was associated with significant improvement of LV performance (Tei index: 0.56±0.18 vs. 0.62±0.16, P<0.05). Conclusions: BB pacing preserves atrial synchrony, and might be more favorable than RAA pacing for maximizing hemodynamic efficacy of CRT.  (Circ J 2012; 76: 2799–2806)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 76 (12), 2799-2806, 2012

  一般社団法人 日本循環器学会

キーワード

• Atrial synchrony
• Atrioventricular synchrony
• Bachmann’s bundle pacing
• Cardiac resynchronization therapy

詳細情報

• CRID: 1390001205103060480
• NII論文ID: 10031126051
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-12-0811
• COI: 1:STN:280:DC%2BC38bmsVSjug%3D%3D
• ISSN: 13474820
• ISSN: 13469843
• PubMed: 22972199
• Web Site: https://www.jstage.jst.go.jp/article/circj/76/12/76_CJ-12-0811/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2013307018
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
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