LAU, C.-P., ET AL.: Reversal of Left Ventricular Remodeling by Synchronous Biventricular Pacing in Heart Failure. Synchronous biventricular pacing is a new nonpharmacological supplemental treatment of advanced heart failure associated with electromechanical conduction delay. However, the role of pac ing on left ventricular remodeling is unknown. Eleven patients with New York Heart Association Class III to IV heart failure, a ¡eft ventricular ejection fraction < 35%, and a QRS duration > 140 ms received a biventricular dual chamber pacemaker. Serial echocardiography, 6-minute hall walk, and Minnesota Liv ing with Heart Failure quality-of-life (QOL) questionnaire were performed before and after up to 3 months of pacing. At 3 months there was a significant increase in fractional shortening (P < 0.001), ejection frac tion (P < 0.001), and cardiac output (P < 0.05). The left ventricular end-diastolic volume (245 ± 70 vs 185 ± 37 mL, P < 0.05),, and mitral régurgitation were reduced (P < 0.05), and diastolic filling time was lengthened (P < 0.05). There were also improvements in heart failure symptoms, an increase in 6-minute walk distance, and a decrease in QOL scores. Syn chronous biventricular pacing for 3 months was associated with hemodynamic improvements, reversal of left ventricular remodeling, and increase in left ventricular systolic function, and a decrease in secondary mitral régurgitation. (PACE 2000; 23[Pt.II]:l 722-1725) pacing, heart failure, biventricular, remodeling, left ventricle

The presence of a larger amount of LV area with late Endo-AT and preserved LV myocardium measured by electromechanical mapping could identify patients who have better acute improvement in systolic performance during LV stimulation.

Each group achieved good clinical outcomes with this safe, minimally invasive spinal surgery for the treatment of cervical disc herniation. In addition, no postoperative risk of cervical instability was found.

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The unique ECG appearance of Brugada syndrome is caused by failure of the dome of the action potential to develop. It occurs when the outward currents (mainly Ito) overwhelm the inward currents (mainly Ica) at the end of phase 1 of the action potential. Because Ito becomes less prominent at a faster rate, increased heart rate is associated with decreased ST segment elevation on ECG and probably decreased incidence of ventricular arrhythmia. We present the first report on prevention of ventricular fibrillation in a man with Brugada syndrome by overdrive pacing from his dual chamber implantable cardioverter defibrillator.