Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · May 2007
Avoidance of right ventricular pacing in cardiac resynchronization therapy improves right ventricular hemodynamics in heart failure patients.
Cardiac resynchronization therapy (CRT) applied by pacing the left and right ventricles (BiV) has been shown to provide synchronous left ventricular (LV) contraction in heart failure patients. CRT may also be accomplished through synchronization of a properly timed LV pacing impulse with intrinsically conducted activation wave fronts. Elimination of right ventricular (RV) pacing may provide a more physiological RV contraction pattern and reduce device current drain. We evaluated the effects of LV and BiV pacing over a range of atrioventricular intervals on the performance of both ventricles. ⋯ Synchronized LV pacing produces acute LV and systemic hemodynamic benefits similar to BiV pacing. LV pacing at an appropriate atrioventricular interval prior to the RV sensed impulse provides superior RV hemodynamics compared with BiV pacing.
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J. Cardiovasc. Electrophysiol. · May 2007
Clinical TrialElectrophysiologic manifestations of ventricular tachyarrhythmias provoking appropriate defibrillator interventions in high-risk patients with hypertrophic cardiomyopathy.
Our objective was to determine features of ventricular tachyarrhythmias triggering appropriate implantable cardioverter-defibrillator (ICD) interventions in hypertrophic cardiomyopathy (HCM). ⋯ Sustained monomorphic VT is common in a high-risk cohort with HCM. Sinus tachycardia is often the initiating rhythm, suggesting that high sympathetic drive may be proarrhythmic when a susceptible substrate is present. Antitachycardia pacing is highly effective in terminating VT in this patient population.