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  • 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.
  • 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. (en)
Title
  • Permanent Cardiac Pacing in Children: Choosing the Optimal Pacing Site A Multicenter Study
  • Permanent Cardiac Pacing in Children: Choosing the Optimal Pacing Site A Multicenter Study (en)
skos:prefLabel
  • Permanent Cardiac Pacing in Children: Choosing the Optimal Pacing Site A Multicenter Study
  • Permanent Cardiac Pacing in Children: Choosing the Optimal Pacing Site A Multicenter Study (en)
skos:notation
  • RIV/00064203:_____/13:10193311!RIV14-MZ0-00064203
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • P(NT12321)
http://linked.open...iv/cisloPeriodika
  • 5
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 95827
http://linked.open...ai/riv/idVysledku
  • RIV/00064203:_____/13:10193311
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • pediatrics; pacing; pacemakers; heart failure; heart block (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • AU - Australské společenství
http://linked.open...ontrolniKodProRIV
  • [E68A6E625F84]
http://linked.open...i/riv/nazevZdroje
  • Circulation
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...vavai/riv/projekt
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 127
http://linked.open...iv/tvurceVysledku
  • Janoušek, Jan
  • Marek, Jan
  • Kubuš, Peter
  • Prinzen, Frits W.
  • van Geldorp, Irene E.
  • Clur, Sally-Ann
  • Delhaas, Tammo
  • Elders, Jan
  • Frias, Patrick
  • Friedberg, Mark
  • Fruh, Andreas
  • Gabbarini, Fulvio
  • Ganame, Javier
  • Gebauer, Roman A
  • Hiippala, Anita
  • Kerst, Gunter
  • Krupičková, Sylvia
  • Nagel, Bert
  • Nuernberg, Jan-Hendrik
  • Nugent, Kelly
  • Papagiannis, John
  • Rosenthal, Eric
  • Tisma-Dupanovic, Svjetlana
  • Tomaske, Maren
  • Tsao, Sabrina
  • Volaufova, Julia
  • Wren, Christopher
  • de Guillebon, Maxime
http://linked.open...ain/vavai/riv/wos
  • 000314691700015
issn
  • 0009-7322
number of pages
http://bibframe.org/vocab/doi
  • 10.1161/CIRCULATIONAHA.112.115428
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