Effect of left ventricular function on long-term left ventricular pacing and sensing threshold.

Hung-Fat Tse; Cannas Yu; Vince E Paul; Giuseppe Boriani; Andreas Schuchert; Juan Leal del Ojo; Klaus Malinowski; Jean-Jacques Blanc; Chu-Pak Lau

doi:10.1023/a:1025312319011

PubMed · 12975566

Effect of left ventricular function on long-term left ventricular pacing and sensing threshold.

Hung-Fat Tse·Cannas Yu·Vince E Paul·Giuseppe Boriani·Andreas Schuchert·Juan Leal del Ojo·Klaus Malinowski·Jean-Jacques Blanc·Chu-Pak Lau

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Abstract

BACKGROUND: The effect of left ventricular (LV) systolic function on the long-term left ventricular pacing and sensing threshold is unclear. METHODS AND RESULTS: We studied the effect of LV ejection fraction (LVEF) on the LV pacing and sensing threshold in 56 patients (mean age: 70.2 +/- 10.5 years) underwent permanent LV pacing using a self-retaining coronary sinus lead (Model 1055 K, St Jude Medical, USA). In 49 patients, the LV lead was implanted for conventional pacemaker indication (sick sinus syndrome = 14, heart block = 26 or slow atrial fibrillation = 9). The remaining 7 patients were implanted for congestive heart failure. The LV pacing and sensing threshold, and lead impedance were compared between patients with LVEF <40% (Group 1, n = 28) and LVEF >40% (Group 2, n = 28) during implant and at 3-month follow up. The LV pacing lead was successfully implanted in all patients without any lead dislodgement on follow-up. At implant, Group 1 patients had a significant lower R wave amplitude, but similar LV pacing threshold and lead impedance as compared to Group 2. However, at 3-month follow-up, Group 1 patients had a significantly higher LV pacing threshold compared to Group 2 patients. There were no significant differences in the sensing threshold and lead impedance between the two groups. Furthermore, there was also a significant interval increase in LV pacing threshold in Group 1 patients (0.94 +/- 0.12 V) after 3 months, but not in Group 2 patients (0.16 +/- 0.08 V, p < 0.01). CONCLUSIONS: The results of this study suggest that the LV systolic function has a significant impact on the long-term LV pacing threshold. The long-term left ventricular pacing threshold in patients with left ventricular systolic dysfunction increased after implant and was higher than patients with normal left ventricular systolic function.

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Hung-Fat Tse, Cannas Yu, Vince E Paul, Giuseppe Boriani, Andreas Schuchert, Juan Leal del Ojo, Klaus Malinowski, Jean-Jacques Blanc, Chu-Pak Lau. 2003. Effect of left ventricular function on long-term left ventricular pacing and sensing threshold.. https://doi.org/10.1023/a%3A1025312319011

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