Biventricular Pacing: Is Acute Hemodynamic Evaluation Useful to Select Patients?

  • F. Di Pede
  • G. Gasparini
  • A. Raviele
Conference paper


Acute hemodynamic studies are currently performed to evaluate the effects of drugs or devices on cardiac performance and to understand the mechanisms by which they act. Cardiac pacing has been used to correct bradycardia. However, right ventricular pacing was found to worsen ventricular performance, and new pacing sites capable of preserving ventricular function have been studied. More recently, cardiac pacing has been used to treat congestive heart failure [1–5].


Left Ventricle Mitral Regurgitation Ventricular Pace Biventricular Pace Inferior Myocardial Infarction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    HochlertnerM, HörtnaglH, Choi-KeungNg et al (1990)Usefulness of physiologic dual-chamber pacing in drug-resistant idiopathicdilated cardiomyopathy. Am J Cardiol 66:198–202CrossRefGoogle Scholar
  2. 2.
    BerckerSJD, Xiao HB, Sparrow J et al (1992) Effects of dual-chamber pacing with shortatrioventricular delay in dilated cardiomyopathy. Lancet 40:1308CrossRefGoogle Scholar
  3. 3.
    SaxonLA, Stevenson WG, Middlekauff HR et al (1993) Increased risk of progressivehemodynamic deterioration in advanced heart failure patients requiringpermanent pacemakers. Am Heart J 125:1306–1310PubMedCrossRefGoogle Scholar
  4. 4.
    CazeauS, RitterP,Bakdach S etal(1994) Four chamber pacing in dilated cardiomyopathy. Pace 17 (II): 1974–1979PubMedCrossRefGoogle Scholar
  5. 5.
    CazeauS, RitterP,Lazarus A etal(1996) Multisite pacing for end-stage heart failure: early experience. PACE19:1748–1757PubMedCrossRefGoogle Scholar
  6. 6.
    AlboniP (1981) Bundle branch blocks. In: P Alboni (ed) Intraventricular conductiondisturbances. Martinus Nijhoff, The Hague Boston London, pp 9–56CrossRefGoogle Scholar
  7. 7.
    Vassallo JA,CassidyDM, Miller JM etal(1986) Left ventricular endocardial activation during right ventricular pacing:effect of underlying heart disease. J Am Coll Cardiol 7:1228–1233PubMedCrossRefGoogle Scholar
  8. 8.
    Piccolo E, Raviele A, Delise P (1981) I ritardi diattivazione ventricolare. In: Piccolo E (ed) Elettrocardiografia evettorcardiografìa. Piccin, Padua, pp 131–204Google Scholar
  9. 9.
    LittleWC,Braunwald E(1997) Assessment of cardiac function. In: Braunwald E (ed) Heartdisease. Saunders, Philadelphia, pp 421–444Google Scholar
  10. 10.
    Yang SS, Bentivoglio LG, Maranhão V, Goldberg H (eds) (1972) From cardiaccatheterization data to hemodynamic parameters. Davis, Philadelphia, pp 157–201Google Scholar
  11. 11.
    GrinesCL, Bashore TM,BoudoulasH etal(1989) Functional abnormalities in isolated left bundle branch block.Circulation 79:845–853PubMedCrossRefGoogle Scholar
  12. 12.
    FeigenbaumH(ed) (1986) Echocardiographic findings with altered electrical activation. Echocardiography. Lea & Febiger,Philadelphia, pp 230–248Google Scholar
  13. 13.
    Lister JW, Klotz KH, Jomain SL et al (1964) Effect of pacemaker site on cardiac output and ventricularactivation in dogs with complete heart block. Am J Cardiol 14:494–503PubMedCrossRefGoogle Scholar
  14. 14.
    XiaoHB, Brecker SJD, Gibson DG (1992) Effects of abnormal activation on the timecourse of the left ventricular pressure pulse in dilated cardiomyopathy. BrHeart J 68:403–407Google Scholar
  15. 15.
    Xiao HB, Brecker SJD, Gibson DG (1993) Differing effectsof right ventricular pacing and left bundle branch block on left ventricularfunction. Br Heart J 69:166–173PubMedCrossRefGoogle Scholar
  16. 16.
    XiaoHB, Roy C, Gibson DG (1994) Nature of ventricular activation in patients withdilated cardiomyopathy: evidence for bilateral bundle branch block. Br Heart J72:167–174CrossRefGoogle Scholar
  17. 17.
    Foster AH, Gold MR, McLaughlin JS (1995) Acute hemodynamic effects ofatriobiventricular pacing in humans. Ann Thorac Surg 59:294–300PubMedCrossRefGoogle Scholar
  18. 18.
    BlancJJ, Etienne Y, Gilard M et al (1997) Evaluation of different ventricular pacingsites in patients with severe heart failure. Circulation 96:3273–3277PubMedCrossRefGoogle Scholar
  19. 19.
    LeclercqC, Cazeau S, Le Breton H et al (1998) Acute hemodynamic effects ofbiventricular DDD pacing in patients with end-stage heart failure. J Am CollCardiol 32:1825–1831CrossRefGoogle Scholar
  20. 20.
    AuricchioA, Klein H, Tockman B et al (1999) Transvenous biventricular pacing for heartfailure: can the obstacles be overcome? Am J Cardiol 83:136D–142DPubMedCrossRefGoogle Scholar
  21. 21.
    KassDA, Chen CH, Fetics B et al (1998) Ventricular function in patients withdilated cardiomyopathy is improved by VDD pacing at left but not rightventricular sites. J Am Coll Cardiol 31:1015–1029Google Scholar
  22. CurryCW, Fetics B, Wyman B et al (1998) Mechanical dyssynchrony at rest and with adrenergicstimulation in patients with dilated cardiomyopathy studied by MRI-tagging: canit help identify candidates for chronic VDD pacing therapy? Circulation [SupplI]:302 (abstr)Google Scholar
  23. 23.
    CazeauS, RitterP,Lazarus A etal(1996) How to predict the hemodynamic benefit of multisite pacing for heartfailure. Eur JCPE 6:544Google Scholar

Copyright information

© Springer-Verlag Italia 2000

Authors and Affiliations

  • F. Di Pede
    • 1
  • G. Gasparini
    • 1
  • A. Raviele
    • 1
  1. 1.Reparto di CardiologiaOspedale Umberto IMestre, VeniceItaly

Personalised recommendations