Abstract 11125: Increasing Stimulus Strength of Coronary Sinus Pacing Improved Left Ventricular Mechanical Dyssynchrony and Contractile Function in Patients With Reduced Ejection Fraction
Introduction: Increasing stimulus strength of left ventricular (LV) coronary sinus pacing decreases QRS duration and inter-ventricular conduction time.
Hypothesis: Increasing stimulus strength of LV coronary sinus pacing improves LV mechanical dyssynchrony and myocardial function.
Methods: We studied 36 patients with 6±4 months after cardiac resynchronization therapy (LV ejection fraction: 39±11%). The LV pacing lead was positioned in lateral or posterolateral coronary sinus vein. We measured standard deviation (SD) of time to negative peak circumferential strain (time-CircS) in 6 segments and peak global circumferential strain value (CircS) using two-dimensional speckle-tracking echocardiography to evaluate LV mechanical dyssynchrony and myocardial contractile function, respectively. Low (1.3±0.6V), clinical (2.6±1.0V), and high (7.3±1.1V) voltage conditions of LV coronary sinus pacing were performed under right ventricular pacing-off.
Results: SD of time-CircS and global CircS under high voltage LV coronary sinus pacing was significantly better than those under low and clinical voltage (78±38 vs. 90±48 and 92±43msec, p=0.014 and 0.016; 5.7±3.4 vs. 5.4±3.3 and 5.4±3.4%, p=0.007 and 0.003). Moreover, global CircS significantly correlated with SD of time-CircS (r= -0.54, p<0.001, n=108).
Conclusions: Increasing stimulus strength of LV coronary sinus pacing improved LV mechanical dyssynchrony and LV contractile function, leading clinical implication for better management of heart failure patients with cardiac resynchronization therapy.
Author Disclosures: K. Tatsumi: None. H. Tanaka: None. K. Matsumoto: None. D. Kumiko: None. Y. Hatani: None. K. Hatazawa: None. H. Matsuzoe: None. J. Ooka: None. H. Sano: None. H. Shimoura: None. T. Sawa: None. Y. Motoji: None. Y. Mochizuki: None. K. Ryo: None. K. Fukuzawa: None. K. Hirata: None.
- © 2015 by American Heart Association, Inc.