investigation of the bnp level changes in blood stream in different modes and lead locations after pacemaker implementation

as it has proven the increase of mechanical strain could resulted to increase of bnp (protein brain natriuretic peptide) in blood stream of implanted patient pacemakers. we measured the bnp concentration in blood due to different mode and lead implantation location of pacemaker in the time period of three month. the aim of study was the investigation of change trend of bnp level after pacemaker implantation. one hundred and three pacemaker implanted patients were monitored. patients were in age span of 54±12 including 48 men and 55 women. a group of 44 programmed in dddr mode and a group of 59 of them programmed in vvir mode by the recommendation of cardiologist. between these two groups the pacing levels of pacemakers divided to under and above fifty percent. some of these pacemaker leads were located at apex of the right ventricle and the others were located in septum wall in right ventricle. to evaluate bnp change during a period of three month the bnp’s measured in pg/ml(pictogram/ milliliter) within 24 hours of implantation(bnp1) and after three month(bnp2). for different class of pacemaker implantations the ratio of final measurement (bnp2) is divided to after implantation measurements (bnp1). consensus result are showing that in vvir mode the ratio is 1.54±0.3 and in dddr mode the ratio is 0.38±0.17 with acceptable standard error means(<0.04). also comparisons are made for lead location at two modes of dddr and vvir separately. in dddr mode the ratio for apex location is 0.49±0.12 and for septum location is 0.22±0.34 with acceptable standard error means(<0.02). in vvir mode the ratio for apex location is 1.71±0.27 and for septum location is 1.28±0.09 with acceptable standard error means(<0.04). therefore bnp decrease in dddr mode is more than vvir mode programming. in both cases of dddr and vvir modes the septum location of the leads would result to more decrease of bnp.