RT-39
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Fourier analysis for hemodynamic
study in new indications of pacemakers
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Maurizio Santomauro, Sandro
Betocchi, Michele Damiano*, Fernando Coltorti, Francesco Solimene, Natale Marrazzo,
Massimo Chiariello.
Department of Cardiology and Cardiac Surgery, *Department of Nuclear Medicine,
Medical School, Federico II University of Naples, Italy
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Abstract
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Background. The phase image analysis
is one of the best noninvasive methods to study paced patients. The evaluation of altered
interventricular and intraventricular activation sequences induced by different pacing
modes can be performed during radionuclide ventriculography by the Fourier analysis.
Methods. We revised our data on 60 patients with different pacing
modes compared to subjects in sinus rhythm. All patients and normals underwent
radionuclide ventriculography and planar gated blood pool scintigraphy at rest and during
pacing.
Results. This technique showed an evident asynchronism of contraction
and relaxation of each ventricle and the standard deviation of phase angle (s), calculated
by computer, is greater during VVI pacing compared to sinus rhythm for LV and RV
ventricles (LV s: 16° ± 3 vs 10° ± 4, p < 0.001; RV s: 32° ± 6 vs 12° ± 4, p
< 0.001). In the VVIR paced patients, the LV s was 19.5° ± 2 (p < 0.001), while RV
s was 29.6° ± 5 (p < 0.001). Instead in patients with DDD pacing the s value of LV
was 16.4° ± 3 (p < 0.01), while for the RV s was 28.7° ± 5 (p < 0.01). Moreover,
patients with VDD showed LV s of 15.4° ± 4 (p < 0.05), while the RV s was 27.9° ± 4
(p < 0.01).
Conclusions. The technique of Fourier analysis permits us to examine
the effects of a temporal inhomogeneity induced by different pacing modes, and it can be
utilized to assess the optimal atrio-ventricular delay in VDD and DDD paced patients,
particularly those with hypertrophic and dilated cardiomyopathy.
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Key Words
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Pacing
VDD pacemakers, DDD pacemakers, radionuclide ventriculography, Fourier analysis, OA
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