Effects of asynchronous ventricular activation on myocardial adrenergic innervation in patients with permanent dual-chamber pacemakers. An I123-metaiodobenzylguanidine cardiac scintigraphic study

Simantirakis, Emmanuel N.; Prassopoulos, Vassilios; Chrysostomakis, Stavros I.; Kochiadakis, Georgios E.; Koukouraki, S.; Lekakis, John; Karkavitsas, Nikolaos; Vardas, Panos

doi:10.1053/euhj.2000.2482

Cited by 38 publications

(23 citation statements)

References 37 publications

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“…При стимуля-ции верхушки ПЖ наблюдалось снижение ударного объ-ема по сравнению со стимуляцией правого предсердия [25]. Описанные изменения сократимости в областях наиболее ранней электрической активации миокарда приводят к нарушению адренергической иннервации [18,26], уменьшению метаболических потребностей [46], сни-жению потребления кислорода, фиброзу и истончению миокарда [12].…”

Section: патогенез неблагоприятных последствий апикальной пж-стимуляцииunclassified

“…Наиболее вероятно, что нарушения перфузии обу-словлены перераспределением коронарного кровотока вследствие ауторегуляции сосудистого тонуса из-за раз-ницы преднагрузки на различные участки миокарда [1, 8,27]. Другими возможными механизмами могут являться вазоконстрикция вследствие повышения тканевого нор-эпинефрина в зоне стимуляции [18,26] и поражение ми-кроциркуляторного русла за счет фиброзно-дегенератив-ных процессов [12]. Дефекты перфузии могут сочетаться с нарушениями локальной сократимости в соответствую-щих зонах, которые невозможно отличить от рубцового поражения миокарда вследствие перенесенного инфаркта [36].…”

Section: патогенез неблагоприятных последствий апикальной пж-стимуляцииunclassified

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Importance of the heart failure mechanisms during permanent single-chamber cardiac pacing for optimization of rate-adaptive mode

Kuznetsova¹,

Андреев²,

Сыркин³

et al. 2015

Kardiol. serdechno-sosud. khir.

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При постоянной электрокардиостимуляции сердца риск сердечной недостаточности (СН) повышен. В настоящем обзоре освещены механизмы развития СН при однокамерной электрокардиостимуляции сердца и основные подходы к преодолению данной проблемы. Особое внимание уделено обсуждению возможностей оптимизации режима частотной адаптации для уменьшения СН. Ключевые слова: постоянная однокамерная электрокардиостимуляция сердца, апикальная правожелудочковая стимуля-ция, хронотропная некомпетентность, сердечная недостаточность, режим частотной адаптации.The risk of heart failure in increased in case of permanent cardiac pacing. Heart failure mechanisms during permanent singlechamber cardiac pacing and main approaches to overcome these problems are being discussed in the review. Possibilities to optimize rate-adaptive modes for heart failure reducing are emphasized.Keywords: permanent single-chamber cardiac pacing, apical right ventricular pacing, chronotropic incompetence, heart failure, rate-adaptive mode.

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Section: патогенез неблагоприятных последствий апикальной пж-стимуляцииunclassified

Importance of the heart failure mechanisms during permanent single-chamber cardiac pacing for optimization of rate-adaptive mode

Kuznetsova¹,

Андреев²,

Сыркин³

et al. 2015

Kardiol. serdechno-sosud. khir.

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“…Pathomechanisms of Chronic--Stimulated Heart Failure Abnormal Blood and Adrenergic Myocardial Perfusion E. N. Simantirakis et al [19] showed that RVA stimulation, besides blood perfusion disorders in the area of stimulation, also causes disturbances in adrenergic conduction system. This data proves the theory of correlation between the specific place of stimulation and its adequate effect on electrical impulse conduction system and regional blood perfusion.…”

Section: Left Atrium and Mitral Valve Dysfunction -Atrial Fibrillationmentioning

confidence: 99%

Alternative Right Ventricular Pacing Sites

Łuciuk¹,

Łuciuk²,

Gajek³

2015

Adv Clin Exp Med

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Background. The main adverse effect of chronic stimulation is stimulation-induced heart failure in case of ventricular contraction dyssynchrony. Because of this fact, new techniques of stimulation should be considered to optimize electrotherapy. One of these methods is pacing from alternative right ventricular sites. Objectives. The purpose of this article is to review currently accumulated data about alternative sites of cardiac pacing. Material and Methods. Medline and PubMed bases were used to search English and Polish reports published recently.Results. Recent studies report a deleterious effect of long term apical pacing. It is suggested that permanent apical stimulation, by omitting physiological conduction pattern with His-Purkinie network, may lead to electrical and mechanical dyssynchrony of heart muscle contraction. In the long term this pathological situation can lead to severe heart failure and death. Because of this, scientists began to search for some alternative sites of cardiac pacing to reduce the deleterious effect of stimulation. Based on current accumulated data, it is suggested that the right ventricular outflow tract, right ventricular septum, direct His-bundle or biventricular pacing are better alternatives due to more physiological electrical impulse propagation within the heart and the reduction of the dyssynchrony effect. These methods should preserve a better left ventricular function and prevent the development of heart failure in permanent paced patients. As there is still not enough, long-term, randomized, prospective, cross-over and multicenter studies, further research is required to validate the benefits of using this kind of therapy. Conclusions. The article should pay attention to new sites of cardiac stimulation as a better and safer method of treatment (Adv Clin Exp Med 2015, 24, 2, 349-359).

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“…6 On the other side, in patients with dual-chamber pacemaker it was observed that stimulation from the apex of the right ventricle is responsible for regional alteration of the adrenergic innervation of the left ventricular myocardium, as assessed by I(123)-MIBG activity. 7 Magnetic resonance imaging (MRI) has also been used to assess ventricular asynchrony and its response to pacing therapy. 8,9 In patients with non-ischemic heart failure, spatial dyssynchrony, as assessed by cross-correlation analysis of time curves of myocardial circumferential strains delivered from cine-tagging MRI images, was correlated with an impairment of cardiac sympathetic activity.…”

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confidence: 99%

Neuronal damage and abnormal contraction: Is the circle of synchronicity complete?

Marcassa

2019

Journal of Nuclear Cardiology

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Effects of asynchronous ventricular activation on myocardial adrenergic innervation in patients with permanent dual-chamber pacemakers. An I123-metaiodobenzylguanidine cardiac scintigraphic study

Abstract: Stimulation from the apex of the right ventricle leads to regional disturbances of the adrenergic innervation of the left ventricular myocardium, as assessed by I(123)-MIBG activity.

Cited by 38 publications

References 37 publications

Importance of the heart failure mechanisms during permanent single-chamber cardiac pacing for optimization of rate-adaptive mode

Importance of the heart failure mechanisms during permanent single-chamber cardiac pacing for optimization of rate-adaptive mode

Alternative Right Ventricular Pacing Sites

Neuronal damage and abnormal contraction: Is the circle of synchronicity complete?

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