Permanent cardiac pacing in children: choosing the optimal pacing site: a multicenter study
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
PubMed
23275383
DOI
10.1161/circulationaha.112.115428
PII: CIRCULATIONAHA.112.115428
Knihovny.cz E-zdroje
- MeSH
- atrioventrikulární blokáda patologie patofyziologie terapie MeSH
- dítě MeSH
- dysfunkce levé srdeční komory diagnostické zobrazování patofyziologie MeSH
- elektrokardiografie MeSH
- kardiostimulace umělá metody MeSH
- kardiostimulátor * MeSH
- lidé MeSH
- mladiství MeSH
- modely kardiovaskulární MeSH
- průřezové studie MeSH
- rentgendiagnostika hrudníku MeSH
- retrospektivní studie MeSH
- srdeční komory diagnostické zobrazování patologie patofyziologie MeSH
- tepový objem fyziologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: We evaluated the effects of the site of ventricular pacing on left ventricular (LV) synchrony and function in children requiring permanent pacing. METHODS AND RESULTS: One hundred seventy-eight children (aged <18 years) from 21 centers with atrioventricular block and a structurally normal heart undergoing permanent pacing were studied cross-sectionally. Median age at evaluation was 11.2 (interquartile range, 6.3-15.0) years. Median pacing duration was 5.4 (interquartile range, 3.1-8.8) years. Pacing sites were the free wall of the right ventricular (RV) outflow tract (n=8), lateral RV (n=44), RV apex (n=61), RV septum (n=29), LV apex (n=12), LV midlateral wall (n=17), and LV base (n=7). LV synchrony, pump function, and contraction efficiency were significantly affected by pacing site and were superior in children paced at the LV apex/LV midlateral wall. LV dyssynchrony correlated inversely with LV ejection fraction (R=0.80, P=0.031). Pacing from the RV outflow tract/lateral RV predicted significantly decreased LV function (LV ejection fraction <45%; odds ratio, 10.72; confidence interval, 2.07-55.60; P=0.005), whereas LV apex/LV midlateral wall pacing was associated with preserved LV function (LV ejection fraction ≥55%; odds ratio, 8.26; confidence interval, 1.46-47.62; P=0.018). Presence of maternal autoantibodies, gender, age at implantation, duration of pacing, DDD mode, and QRS duration had no significant impact on LV ejection fraction. CONCLUSIONS: The site of ventricular pacing has a major impact on LV mechanical synchrony, efficiency, and pump function in children who require lifelong pacing. Of the sites studied, LV apex/LV midlateral wall pacing has the greatest potential to prevent pacing-induced reduction of cardiac pump function.
Circulation. 2013 Apr 16;127(15):e550 PubMed
Citace poskytuje Crossref.org
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