Biventricular pacing decreases sympathetic activity compared with right ventricular pacing in patients with depressed ejection fraction

Mohamed H. Hamdan, Jason D. Zagrodzky, Jose A. Joglar, Clifford J. Sheehan, Karthik Ramaswamy, Jeffrey F. Erdner, Richard L. Page, Michael L. Smith

Research output: Contribution to journalArticle

125 Scopus citations

Abstract

Background - Although there have been few studies in which the hemodynamic effects of right ventricular (RV) and left ventricular (LV) pacing were compared with those of biventricular (BV) pacing, the autonomic changes during these different pacing modes remain unknown. We hypothesized that BV pacing results in improved hemodynamics and a decrease in sympathetic nerve activity (SNA) compared with single-site pacing. Methods and Results - Thirteen men with a mean ejection fraction of 0.28±0.7 were enrolled in the study. Arterial blood pressure (BP), central venous pressure (CVP), and SNA were recorded during 3 minutes of right atrial (RA)-RV, RA-LV, and RA-BV pacing at a rate 10 beats faster than sinus rhythm. BP was greater during LV (151±7/85±3 mm Hg) and BV (151±6/85±3 mm Hg) pacing than during RV pacing (146±7/82±3 mm Hg) (P<0.05). There were no differences in CVP among all pacing modes (P=0.27). SNA was significantly less (P<0.02) during both LV (606±35 U) and BV (582±41 U) pacing compared with RV pacing (685±32 U) (P<0.02). Although not statistically significant (P=0.08 to 0.14), there was a trend for patients with a narrow QRS to have a lower mean BP and higher SNA during LV pacing than during BV pacing (r=0.42 to 0.49). Conclusions - LV-based pacing results in improved hemodynamics and a decrease in SNA compared with RV pacing in patients with LV dysfunction regardless of the QRS duration.

Original languageEnglish
Pages (from-to)1027-1032
Number of pages6
JournalCirculation
Volume102
Issue number9
DOIs
StatePublished - 29 Aug 2000

Keywords

  • Autonomic
  • Heart failure
  • Nervous system
  • Pacing

Fingerprint Dive into the research topics of 'Biventricular pacing decreases sympathetic activity compared with right ventricular pacing in patients with depressed ejection fraction'. Together they form a unique fingerprint.

  • Cite this

    Hamdan, M. H., Zagrodzky, J. D., Joglar, J. A., Sheehan, C. J., Ramaswamy, K., Erdner, J. F., Page, R. L., & Smith, M. L. (2000). Biventricular pacing decreases sympathetic activity compared with right ventricular pacing in patients with depressed ejection fraction. Circulation, 102(9), 1027-1032. https://doi.org/10.1161/01.CIR.102.9.1027