Functional characteristics of left ventricular synchronization via right ventricular outflow-tract pacing detected by two-dimensional strain echocardiography

• Material Type: 博士論文
• Title: Functional characteristics of left ventricular synchronization via right ventricular outflow-tract pacing detected by two-dimensional strain echocardiography
• Author/Editor: 平山, 康高
• Author Heading: 平山, 康高 ヒラヤマ, ヤスタカ
• Publication Date: 2017-02-01
• Publication Date (W3CDTF): 2017-02-01
• Periodical title: Journal of arrhythmia
• No. or year of volume/issue: 33 1
• Volume: 33
• Issue: 1
• Pages: 28-34
• ISSN (Periodical Title): ISSN : 1880-4276
• Degree grantor/type: 旭川医科大学
• Date Granted: 2017-03-24
• Dissertation Number: 乙467
• Degree Type: 博士（医学）
• Text Language Code: eng
• Target Audience: 一般
• Note (General): PMID：28217226; BACKGROUND: \nRecently, due to the detrimental effects on the ventricular function associated with right ventricular apical (RVA) pacing, right ventricular septal (RVS) pacing has become the preferred pacing method. However, the term RVS pacing refers to both right ventricular outflow-tract (RVOT) and mid-septal (RVMS) pacing, leading to a misinterpretation of the results of clinical studies. The purpose of this study, therefore, was to elucidate the functional differences of RVA, RVOT, and RVMS pacing in patients with atrioventricular block. METHODS: \nWe compared the QRS duration, global longitudinal strain (GLS), and left ventricular (LV) synchronization parameters at the three pacing sites in 47 patients. The peak systolic strain (PSS) time delay between the earliest and latest segments among the 18 LV segments and standard deviation (SD) of the time to the PSS were also calculated for the 18 LV segments at each pacing site using two-dimensional (2D) strain echocardiography. RESULTS: \nRVMS pacing was associated with a significantly shorter QRS duration compared with RVA and RVOT pacing (154.4±21.4 vs 186.5±19.9 and 171.1±21.5 ms, P<0.001). In contrast, RVOT pacing revealed a greater GLS (-14.69±4.92 vs -13.12±4.76 and -13.51±4.81%, P<0.001), shorter PSS time delay between the earliest and latest segments (236.0±87.9 vs 271.3±102.9 and 281.9±126.6%, P=0.007), and shorter SD of the time to the PSS (70.8±23.8 vs 82.7±30.8 and 81.5±33.7 ms, P=0.002) compared with RVA and RVMS pacing. CONCLUSIONS: \nThese results suggest that the functional characteristics of RVOT pacing may be a more optimal pacing site than RVMS, regardless of the pacing QRS duration, in patients with atrioventricular conduction disorders.; application/pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1016/j.joa.2016.04.009.
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 旭川医科大学 : 旭川医科大学学術成果リポジトリ