Biventricular Pacing With Ventricular Fusion by Intrinsic Activation in Cardiac Resynchronization Therapy
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- Guo Tao
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University
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- Li Ruijie
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University
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- Zhang Limei
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University
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- Luo Zhiling
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University
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- Zhao Ling
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University
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- Yang Jun
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University
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- Pu Lijin
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University
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- Hua Baotong
- Department of Cardiology, the First Affiliated Hospital of Kunming Medical University
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抄録
We sought to evaluate the impact of biventricular (BiV) pacing with ventricular fusion by intrinsic atrioventricular nodal (AVN) conduction (BiV + intrinsic pacing) on clinical outcomes in patients with chronic heart failure (CHF) receiving cardiac resynchronization therapy (CRT).<br>A total of 44 patients were randomized to receive either BiV or BiV + intrinsic pacing for one month. Echocardiographic optimization was performed for the BiV pacing mode, while the BiV + intrinsic pacing mode was achieved by titrating AV delay under electrocardiography (ECG) monitoring. Symptoms, quality of life, ECG, echocardiography, and cardiovascular events were recorded at baseline and the end of the follow-up for each pacing mode.<br>Patients undergoing BiV + intrinsic pacing mode had shorter QRS duration compared to those with conventional BiV pacing (118.4 ± 21.6 ms versus 146.4 ± 5.3 ms, P < 0.0001). Also, these patients had improved echocardiographic left ventricular fractional shortening (LVFS) (17.4 ± 5.9 versus 15.7 ± 4.9, P = 0.019), higher left ventricular ejection fraction (LVEF) (35.5 ± 9.7 versus 32.7 ± 9.7, P = 0.048), longer 6-minute walk test (6MWT) (372.5 ± 80.9 m versus 328.7 ± 108.9 m, P = 0.0001), and better Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores (12.5 ± 6.6 versus 18.2 ± 12.3, P = 0.0001).<br>Treating CHF patients with BiV+intrinsic pacing resulted in improved cardiac function and quality of life. BiV + intrinsic pacing can be used in CHF patients with sinus rhythm and normal AV nodal conduction to improve CRT efficacy.
収録刊行物
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- International Heart Journal
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International Heart Journal 56 (3), 293-297, 2015
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