| Objective To compare the effects of right ventricular apex(RVA) pacing and right ventricular outflow tract(RVOT)pacing on synchronization interventricular and intraventricular and left ventrieular(LV)function in patients with complete atrioventricular block.Methods 38 patients with complete atrioventricular block, admitted to hospital from June 2007 to June 2008, were randomized received RVA or RVOT pacing. Out of 38 patients 18 were received RVA pacing and 20 were received RVOT pacing. Left ventricular end diastolic diameter(LVEDD), left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (EF), E/A, the interventricular mechanical delay (IVMD) and septal to posterior wall motion delay (SPWMD) were measured before operation,1 month and 12month after implanting, respectively.Result 38 patients were followed up. There are no significant differences between two groups in basic clinical characteristic. LVEDD, LVESD, LVEF, E/A, IVMD, SPWMD measured before operation has no significant differences between two groups. There is no difference between groups in LVEDD, LVESD, LVEF, E/A one month after operation. Compared with the RVOT group, RVA pacing increased IVMD and SPWMD significantly [IVMD (9.83±6.01)ms vs (31.95±7.86)ms, P=0.02], [SPWMD (97.83±20.81)ms vs (84.6±10.89)ms, P=0.023]. One year after oparation, there is no difference between groups in E/A, however, compared with the RVOT group, RVA pacing increased LVEDD and LVESD [LVEDD (49.11±2.39)mm vs(47.4±1.96)mm,P=0.02], [LVESD (34.28±3.41)mm vs (32.5±1.5)mm,P=0.04], also, RVA pacing decreased LVEF [(59.56±3.38)% vs(62.8±2.14)%,P=0.001] and increased IVMD and SPWMD [IVMD (48.83±8.42)ms vs (41.5±11.01)ms, P=0.02], [SPWMD (143.89±12.43) vs (136.45±8.37), P=0.03] significantly. Conclusion Compared with RVOT pacing, RVA pacing induced mechanical dyssynchrony and impairs left ventricular function. |
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