Right Ventricular Septal Pacing vs. Right Ventricular Apical Pacing Following Atrioventricular Node Ablation: A 10-Year Follow-up
Journal Title: International Cardiovascular Research Journal - Year 2018, Vol 12, Issue 3
Abstract
Background: Right Ventricular Septal (RVS) pacing is often recommended as a more physiological alternative to Right Ventricular Apical (RVA) pacing. Objectives: This study aimed to determine the long-term outcomes in patients persistently paced following Atrioventricular Node (AVN) ablation. Materials and Methods: This study was conducted on 200 patients who underwent Permanent Pacemaker (PPM) implantation prior to AVN ablation with either RVA- or RVS-pacing. Primary endpoints were hospitalization due to Heart Failure (HF) and death. Secondary endpoints included changes in Ejection Fraction (EF), inter- and intraventricular dyssynchrony measures, and paced QRS duration. Demographic data were obtained from all patients. In addition, CT chest examinations were analyzed to confirm RVS lead position. Results: The mean survival time from AVN ablation was 6.32 ± 4.294 years in the RVA group and 3.00 ± 2.546 years in the RVS group (hazard ratio = 3.512, P = 0.0001). The results showed no significant differences between the two sites regarding hospitalization due to HF. Baseline and follow-up EFs were respectively 48.4 ± 13.8% and 53.1 ± 8.5% for RVA pacing and 52.0 ± 10.6% and 55.2 ± 11.3% for RVS pacing (P = 0.911). Moreover, 76% of the patients in the RVS group had a septal lead confirmed on CT chest review. Twentyfour percent of the RVS leads were in alternate sites, including the RVA and free wall. Conclusions: The results revealed was no diminution in EF with either lead position at long-term follow-up. The mortality rate was significantly less in RVA pacing compared to documented septal pacing although a quarter of the RVS leads were found in alternate sites on CT chest review.
Evaluation of Celiac Disease in Children with Dilated Cardiomyopathy
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Association Assessment of Paraoxonase 1 Gene Polymorphism with Coronary Artery Disease in Golestan, Iran
Background: Cardiovascular disease (CVD) is the most common cause of mortality and morbidity worldwide. Coronary artery disease (CAD) is the leading cause of CVD. In CAD, atherosclerotic plaques lead to coronary artery s...
Left Atrial Appendage Ejection Flow Waves in Differentiation of Atrial Flutter from Atrial Fibrillation
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The Association between Serum Resistin Level and Presence or Severity of Coronary Heart Disease
Background: Obesity is a well-known principal risk factor for metabolic disorders and cardiovascular diseases. Resistin is one of adipocyte-derived molecules, which plays important roles in inflammation as well as in end...
Investigating the Efficiency of D-Dimer Test in Diagnosis of Aortic Dissection: A Systematic Study and Meta-Analysis
Background: Aortic dissection is a rare and important emergency condition, which usually involves a high mortality rate. Yet, early diagnosis of the disorder would increase the survival rate significantly. Objectives: Th...