Physiological stimulation in preserved ejection fraction: A randomized trial
نویسندگان
چکیده
Abstract Funding Acknowledgements Type of funding sources: None. Introduction Right ventricular stimulation in the apex (RVAS) produce dysynchrony, leading to left ventricle systolic dysfunction (LVSD) some cases. Circumstances that can worsen LVSD are a high burden RVAS, and presence previous and/or intraventricular conduction disease (IVCD). Direct activation specialized system with physiological (PS) preserve this pattern shorten de QRS when impairment is proximal pacing site. Most studies PS has been focused on patients LVSD, few scarce evidences regarding pacients without LVSD. Objectives methods This parallel, single blinded, unicentric, randomized trial preserved mild reduced ejection fraction (LVEF) submitted pacemaker implantation due atrioventricular block (AVB), IVCD (wide QRS) an anticipated rate pacing. Patients were 1:1 RVAS vs followed for 6 months. Clinical, ECG, echocardiography analytic parameters compared. The primary endpoint was change LVEF at months each group. secondary endpoints changes end-diastolic diameter (LVEDD), duration, pro–B-type natriuretic peptide (NT-proBNP), NYHA class, Minnesota Living Heart Failure Questionnaire (MLWHFQ) Results study included 57 77±9,6 years. Of all patients, 53% treated 47% PS. There 2 crossover technical difficulties 1 patient apical scar. no differences basal duration (142.08±20,2 ms), (58.87±7,2%), NT-proBNP (3336,03±7258,68 pg/ml), or MLWHFQ (22,19±14,68), between both groups (Table 1). Acutely significant observed among (+16±29 ms group -17±25 group, p<0,001). At follow-up showed non-significant reduction 0.8±1.1% compared 5.1±1.7% (difference 4,26% IC 0,1-8,43 p=0,022). No values NT-ProBNP 2). Conclusions In requiring AVB, QTS preserves RVAS.
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ژورنال
عنوان ژورنال: Europace
سال: 2023
ISSN: ['1099-5129', '1532-2092']
DOI: https://doi.org/10.1093/europace/euad122.365