Long–Term Effect of VVI Pacing on Atrial and Ventricular Function in Patients with Sick Sinus Syndrome

Paxinos, George; Katritsis, Demosthenes G.; Kakouros, Stavros; Toutouzas, Pavlos; Camm, A. John

doi:10.1111/j.1540-8159.1998.tb00130.x

Cited by 23 publications

(16 citation statements)

References 16 publications

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“…The sections were mounted on slides, stained with cresyl violet solution, and examined by light microscopy. Slices were evaluated for proper electrode placement in the lateral hypothalamus based on Paxinos and Watson [24]. Electrode placement was within the lateral hypothalamus for all animals evaluated.…”

Section: Methodsmentioning

confidence: 99%

Estradiol modulates anhedonia and behavioral despair in rats and negative affect in a subgroup of women at high risk for postpartum depression

Schiller

O’Hara

Rubinow

et al. 2013

Physiology & Behavior

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In an effort to address inconsistencies in the literature, we tested a cross-species estrogen withdrawal model of postpartum depression (PPD) with a series of rodent experiments and a prospective, naturalistic human study. All rats were ovariectomized prior to experimentation. The first rat experiment examined the effects of low- and high-dose estradiol administration and withdrawal on lateral-hypothalamic self-stimulation, a behavioral index of anhedonia, in experimental (n=7) and vehicle-only control animals (n=7). The second rat experiment examined the effects of high-dose estradiol withdrawal on activity and immobility during the forced swim test, an index of behavioral despair, in a separate group of experimental (n=8) and vehicle-only control animals (n=8). In the human study, women with (n=8) and without (n=12) a history of PPD completed mood ratings and collected saliva samples (to assess estradiol levels) daily during the third trimester of pregnancy through 10 days postpartum. The presence of PPD was assessed at one month postpartum. In the animal studies, rats in the estradiol withdrawal group demonstrated significantly greater immobility and less swimming than controls. Estradiol withdrawal resulted in reduced responding for electrical stimulation (multiple intensities) relative to estradiol administration. In the human study, there was no significant association between estradiol and negative affect among women with or without a history of PPD. However, there was a correlation between daily estradiol levels and negative affect in the women with incident PPD at one month postpartum. Despite important cross-species differences, both the rat and human studies provided evidence of the effects of estradiol on perinatal depressive symptoms.

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Section: Methodsmentioning

confidence: 99%

Estradiol modulates anhedonia and behavioral despair in rats and negative affect in a subgroup of women at high risk for postpartum depression

Schiller

O’Hara

Rubinow

et al. 2013

Physiology & Behavior

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“…It might reflect more profound changes of atrial function caused by long-term ventricular stimulation, which was significantly longer in this subgroup of patients. 22 In conclusion, a pacemaker upgrade performed after a long-term ventricular pacing resulted almost consistently in the improvement of hemodynamics and was associated with the improved exercise capacity. In patients with SSS it was followed by the improvement of the qualityof-life that had been also shown in some previous studies.…”

Section: Stroke Volumementioning

confidence: 75%

Effect of Restoration of AV Synchrony on Stroke Volume, Exercise Capacity, and Quality‐of‐Life: Can We Predict the Beneficial Effect of a Pacemaker Upgrade?

Prech

Grygier²,

Mitkowski³

et al. 2001

Pacing Clinical Electrophis

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The aim of this study was to assess to what extent patients with VVIR pacemakers and without overt symptoms of a pacemaker syndrome benefit from a pacemaker upgrade, and if a preoperative noninvasive measurement of the change in stroke volume (SV) could predict the effect of a pacemaker upgrade. The study group consisted of 20 (12 women, 8 men) VVIR patients with a mean age of 60 years. The indication for the first implantation was AV block in 13 patients and SSS in 7. The mean time of a ventricular pacing was 77 months. The objective (echocardiography, an exercise capacity) and the subjective (the quality-of-life) parameters investigated in patients during ventricular pacing were compared to results obtained 2 months and 1 year after a pacemaker upgrade. To assess preoperatively a change in a SV expected after upgrading, attempts were made to restore AV synchronization by the use of a transesophageal pacemaker. An increase in SV (from 5% to > 35%) during temporary AV resynchronization was observed in each patient. Values of SV increase correlated with those obtained 2 months (r = 0.65; P < 0.01) and 1 year (r = 0.66; P < 0.01) after an upgrade. Superior hemodynamics was associated with a significant improvement of an exercise capacity in both subgroups of patients. The most significant improvement in the quality-of-life was observed in patients with SSS. We did not find correlations between SV and the quality-of-life assessed 2 months (r = 0.043; NS) or 1 year (r = 0.02; NS) after an upgrade. In conclusion, a pacemaker upgrade performed after a long-term ventricular pacing resulted almost consistently in the improvement of hemodynamics and was associated with an increase of exercise capacity. In patients with SSS it was followed by the significant improvement of their quality-of-life. Such a relation was not observed in patients with AV block as some of them (especially those with VVIR pacemakers) felt quite well during ventricular pacing. The proposed preoperative echocardiographic evaluation may precisely predict the degree of hemodynamic improvement expected after a pacemaker upgrade.

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“…RV apical pacing reduces the LV ejection fraction [ 7 ] and increases heart failure [ 8 ]. It leads to abnormal myocardial perfusion [ 9 ], histologic remodeling [ 10 ], arrhythmogenesis [ 11 ], and neurohormonal activation [ 12 ].…”

Section: Rv Apical Pacing: Evidence Of Harmmentioning

confidence: 98%

Selective site pacing: Rationale and practical application

Parekh¹,

Steín

2008

Curr Cardiol Rep

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Although it has become traditional to place permanent pacemaker leads at the right ventricular apex and right atrial appendage, pacing from these locations poorly mimics normal physiology. A growing evidence base shows that right ventricular apical pacing results in ventricular dyssynchrony and various adverse effects. Provocative data from early trials suggest that pacing from alternate sites in the right ventricle--His bundle pacing, para-Hisian pacing, septal right ventricular outflow tract pacing, and right ventricular midseptal pacing--may lead to improved results. Similarly, early data suggest that right atrial pacing near Bachmann's bundle may lead to superior outcomes when compared with pacing from the right atrial appendage. Several large-scale, randomized clinical trials are now under way to establish the future role of selective site pacing.

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Long–Term Effect of VVI Pacing on Atrial and Ventricular Function in Patients with Sick Sinus Syndrome

Cited by 23 publications

References 16 publications

Estradiol modulates anhedonia and behavioral despair in rats and negative affect in a subgroup of women at high risk for postpartum depression

Estradiol modulates anhedonia and behavioral despair in rats and negative affect in a subgroup of women at high risk for postpartum depression

Effect of Restoration of AV Synchrony on Stroke Volume, Exercise Capacity, and Quality‐of‐Life: Can We Predict the Beneficial Effect of a Pacemaker Upgrade?

Selective site pacing: Rationale and practical application

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