Right ventricular bifocal stimulation in the treatment of dilated cardiomyopathy with heart failure
OBJECTIVE: To describe a new more efficient method of endocardial cardiac stimulation, which produces a narrower QRS without using the coronary sinus or cardiac veins. METHODS: We studied 5 patients with severe dilated cardiomyopathy, chronic atrial fibrillation and AV block, who underwent definitive endocardial pacemaker implantation, with 2 leads, in the RV, one in the apex and the other in the interventricular septum (sub pulmonary), connected, respectively, to ventricular and atrial bicameral pacemaker outputs. Using Doppler echocardiography, we compared, in the same patient, conventional (VVI), high septal ("AAI") and bifocal ("DDT" with AV interval ~ 0) stimulation. RESULTS: The RV bifocal stimulation had the best results with an increase in ejection fraction and cardiac output and reduction in QRS duration, mitral regurgitation and in the left atrium area (p <= 0.01). The conventional method of stimulation showed the worst result. CONCLUSION: These results suggest that, when left ventricular stimulation is not possible, right ventricular bifocal stimulation should be used in patients with severe cardiomyopathy where a pacemaker is indicated.
Principais autores: | Pachón Mateos,José Carlos, Albornoz,Remy Nelson, Pachón Mateos,Enrique Indalécio, Gimenez,Vera Márcia, Pachón Mateos,Juán Carlos, Pachón,Maria Zélia Cunha, Santos Fº,Eusebio Ramos dos, Medeiros,Paulo de Tarso Jorge, Silva,Marco Aurélio Dias da, Paulista,Paulo Paredes, Sousa,José Eduardo Moraes Rêgo, Jatene,Adib Domingos |
---|---|
Formato: | Digital revista |
Idioma: | English |
Publicado em: |
Sociedade Brasileira de Cardiologia - SBC
1999
|
Acesso em linha: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X1999001200003 |
Tags: |
Adicionar Tag
Sem tags, seja o primeiro a adicionar uma tag!
|
Registros relacionados
-
Estimulação ventricular bifocal no tratamento da insuficiência cardíaca com miocardiopatia dilatada
por: PACHÓN MATEOS,José Carlos, et al.
Publicado em: (2000) -
Ablação da fibrilação atrial por cateter com radiofreqüência guiada por mapeamento espectral endocárdico dos "ninhos de FA" em ritmo sinusal
por: Mateos,José Carlos Pachón, et al.
Publicado em: (2007) -
Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes
por: Lobo,Tasso Julio, et al.
Publicado em: (2015) -
Comparação de parâmetros eletrofisiológicos das estimulações cardíacas endocárdicas septal e apical
por: Mateos,Juan Carlos Pachón, et al.
Publicado em: (2012) -
Carotid Sinus Massage in Syncope Evaluation: A Nonspecific and Dubious Diagnostic Method
por: Mateos,José Carlos Pachón
Publicado em: (2018)