Antonello D’Andrea, Valentino Ducceschi*, Barbara Mercurio, Francesca Panico, Salvatore D’Isa, Pio Caso**, Berardo Sarubbi*, Gerardo Nigro, Biagio Liccardo, Lucio Santangelo, Aldo Iacono, Maurizio Cotrufo.
Universita Napoli, *Dottorato di Ricerca in Scienze Cardiologiche e Cardiochirurgiche - Seconda Universita Napoli, **Azienda Ospedaliera Monaldi, Napoli, Italy
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Dual-chamber pacing is presently considered superior to ventricular
demand pacing for the treatment of brady arrhythmias because it allows the maintenance of atrioventricular (AV) synchronization
and therefore ensures a more physiological ventricular diastolic filling and also a better systolic function1,2. Previous papers outlined
the influence exerted by heart rate (HR) and AV delay changes on left ventricular diastolic filling pattern in patients with dual-chamber
pace-makers3,4. However, right ventricular adaptation to different DDD pacing modes has not been satisfactorily investigated yet.
Pacing from the apex of the right ventricle alters the segmental contraction-relaxation sequence of both the
ventricles5,6, producing
an activation wave-front spreading asynchronously from right to left and from the apex to the base of the heart.
Aim of our study was to evaluate in patients paced in the DDD mode the combined effects of AV delay and heart rate changes on
segmental right and left ventricular diastolic function by use of tissue Doppler echocardiography (TDE), a new technique which
provides accurate information about segmental myocardial motion during the cardiac cycle7-9.
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