Ventricular pacing – Electromechanical consequences and valvular function
Although great strides have been made in the areas of ventricular pacing, it is still appreciated that dyssynchrony can be malignant, and that appropriately placed pacing leads may ameliorate mechanical dyssynchrony. However, the unknowns at present include: 1. The mechanisms by which ventricular pa...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2016-01-01
|
| Series: | Indian Pacing and Electrophysiology Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0972629216300183 |
| _version_ | 1819031031292887040 |
|---|---|
| author | Elisa Ebrille Christopher V. DeSimone Vaibhav R. Vaidya Anwar A. Chahal Vuyisile T. Nkomo Samuel J. Asirvatham |
| author_facet | Elisa Ebrille Christopher V. DeSimone Vaibhav R. Vaidya Anwar A. Chahal Vuyisile T. Nkomo Samuel J. Asirvatham |
| author_sort | Elisa Ebrille |
| collection | DOAJ |
| description | Although great strides have been made in the areas of ventricular pacing, it is still appreciated that dyssynchrony can be malignant, and that appropriately placed pacing leads may ameliorate mechanical dyssynchrony. However, the unknowns at present include:
1. The mechanisms by which ventricular pacing itself can induce dyssynchrony;
2. Whether or not various pacing locations can decrease the deleterious effects caused by ventricular pacing;
3. The impact of novel methods of pacing, such as atrioventricular septal, lead-less, and far-field surface stimulation;
4. The utility of ECG and echocardiography in predicting response to therapy and/or development of dyssynchrony in the setting of cardiac resynchronization therapy (CRT) lead placement;
5. The impact of ventricular pacing-induced dyssynchrony on valvular function, and how lead position correlates to potential improvement.
This review examines the existing literature to put these issues into context, to provide a basis for understanding how electrical, mechanical, and functional aspects of the heart can be distorted with ventricular pacing. We highlight the central role of the mitral valve and its function as it relates to pacing strategies, especially in the setting of CRT. We also provide future directions for improved pacing modalities via alternative pacing sites and speculate over mechanisms on how lead position may affect the critical function of the mitral valve and thus overall efficacy of CRT. |
| first_indexed | 2024-12-21T06:39:35Z |
| format | Article |
| id | doaj.art-8e69fb78fadd4d67be77a5e3370cc32d |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-12-21T06:39:35Z |
| publishDate | 2016-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-8e69fb78fadd4d67be77a5e3370cc32d2022-12-21T19:12:45ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922016-01-01161193010.1016/j.ipej.2016.02.013Ventricular pacing – Electromechanical consequences and valvular functionElisa Ebrille0Christopher V. DeSimone1Vaibhav R. Vaidya2Anwar A. Chahal3Vuyisile T. Nkomo4Samuel J. Asirvatham5Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USADivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USADivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USADivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USADivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USADivision of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USAAlthough great strides have been made in the areas of ventricular pacing, it is still appreciated that dyssynchrony can be malignant, and that appropriately placed pacing leads may ameliorate mechanical dyssynchrony. However, the unknowns at present include: 1. The mechanisms by which ventricular pacing itself can induce dyssynchrony; 2. Whether or not various pacing locations can decrease the deleterious effects caused by ventricular pacing; 3. The impact of novel methods of pacing, such as atrioventricular septal, lead-less, and far-field surface stimulation; 4. The utility of ECG and echocardiography in predicting response to therapy and/or development of dyssynchrony in the setting of cardiac resynchronization therapy (CRT) lead placement; 5. The impact of ventricular pacing-induced dyssynchrony on valvular function, and how lead position correlates to potential improvement. This review examines the existing literature to put these issues into context, to provide a basis for understanding how electrical, mechanical, and functional aspects of the heart can be distorted with ventricular pacing. We highlight the central role of the mitral valve and its function as it relates to pacing strategies, especially in the setting of CRT. We also provide future directions for improved pacing modalities via alternative pacing sites and speculate over mechanisms on how lead position may affect the critical function of the mitral valve and thus overall efficacy of CRT.http://www.sciencedirect.com/science/article/pii/S0972629216300183Biventricular pacingResynchronizationRight ventricular pacingAtrioventricular septumDyssynchronyValvular regurgitation |
| spellingShingle | Elisa Ebrille Christopher V. DeSimone Vaibhav R. Vaidya Anwar A. Chahal Vuyisile T. Nkomo Samuel J. Asirvatham Ventricular pacing – Electromechanical consequences and valvular function Indian Pacing and Electrophysiology Journal Biventricular pacing Resynchronization Right ventricular pacing Atrioventricular septum Dyssynchrony Valvular regurgitation |
| title | Ventricular pacing – Electromechanical consequences and valvular function |
| title_full | Ventricular pacing – Electromechanical consequences and valvular function |
| title_fullStr | Ventricular pacing – Electromechanical consequences and valvular function |
| title_full_unstemmed | Ventricular pacing – Electromechanical consequences and valvular function |
| title_short | Ventricular pacing – Electromechanical consequences and valvular function |
| title_sort | ventricular pacing electromechanical consequences and valvular function |
| topic | Biventricular pacing Resynchronization Right ventricular pacing Atrioventricular septum Dyssynchrony Valvular regurgitation |
| url | http://www.sciencedirect.com/science/article/pii/S0972629216300183 |
| work_keys_str_mv | AT elisaebrille ventricularpacingelectromechanicalconsequencesandvalvularfunction AT christophervdesimone ventricularpacingelectromechanicalconsequencesandvalvularfunction AT vaibhavrvaidya ventricularpacingelectromechanicalconsequencesandvalvularfunction AT anwarachahal ventricularpacingelectromechanicalconsequencesandvalvularfunction AT vuyisiletnkomo ventricularpacingelectromechanicalconsequencesandvalvularfunction AT samueljasirvatham ventricularpacingelectromechanicalconsequencesandvalvularfunction |