Comparison of the Acute Effects of Different Pacing Sites on Cardiac Synchrony and Contraction Using Speckle-Tracking Echocardiography

Background: Cardiac pacing in patients with bradyarrhythmia may employ variable pacing sites, which may have different effects on cardiac function. Left bundle branch pacing (LBBP) is a new physiological pacing modality, and the acute outcomes on cardiac mechanical synchrony during LBBP remain uncer...

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Autores principales:	Huilin Xie, Xueying Chen, Yanan Wang, Yufei Cheng, Yingjie Zhao, Yang Liu, Yu Liu, Zhenyi Ge, Haiyan Chen, Xianhong Shu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	cardiac synchrony physiological pacing echocardiography His bundle pacing left bundle branch pacing Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/3a033ead99604636819b9ce43c3919bb
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spelling	oai:doaj.org-article:3a033ead99604636819b9ce43c3919bb2021-11-11T06:18:41ZComparison of the Acute Effects of Different Pacing Sites on Cardiac Synchrony and Contraction Using Speckle-Tracking Echocardiography2297-055X10.3389/fcvm.2021.758500https://doaj.org/article/3a033ead99604636819b9ce43c3919bb2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.758500/fullhttps://doaj.org/toc/2297-055XBackground: Cardiac pacing in patients with bradyarrhythmia may employ variable pacing sites, which may have different effects on cardiac function. Left bundle branch pacing (LBBP) is a new physiological pacing modality, and the acute outcomes on cardiac mechanical synchrony during LBBP remain uncertain. We evaluated the acute effects of four pacing sites on cardiac synchrony and contraction using speckle-tracking echocardiography, and comparisons among four different pacing sites were rare.Methods: We enrolled 21 patients with atrioventricular block or sick sinus syndrome who each sequentially underwent acute pacing protocols, including right ventricular apical pacing (RVAP), right ventricular outflow tract pacing (RVOP), His bundle pacing (HBP), and left bundle branch pacing (LBBP). Electrocardiograms and echocardiograms were recorded at baseline and during pacing. The interventricular mechanical delay (IVMD), the standard deviation of the times to longitudinal peak strain during 17 segments (PSD), and the Yu index were used to evaluate ventricular mechanical synchrony. Layer-specific strain was computed using two-dimensional speckle tracking technique to provide in-depth details about ventricular synchrony and function.Results: Left ventricular ejection fraction (LVEF) and tricuspid annulus plane systolic excursion (TAPSE) were significantly decreased during RVAP and RVOP but were not significantly different during HBP and LBBP compared with baseline. RVAP and RVOP significantly prolonged QRS duration, whereas HBP and LBBP showed non-significant effects. IVMD and PSD were significantly increased during RVAP but were not significantly different during RVOP, HBP, or LBBP. LBBP resulted in a significant improvement in the IVMD and Yu index compared with RVAP. No significant differences in mechanical synchrony were found between HBP and LBBP.Conclusion: Among these pacing modalities, RVAP has a negative acute impact on cardiac synchrony and contraction. HBP and LBBP best preserve physiological cardiac synchrony and function.Huilin XieHuilin XieHuilin XieHuilin XieXueying ChenXueying ChenYanan WangYanan WangYanan WangYufei ChengYufei ChengYufei ChengYingjie ZhaoYingjie ZhaoYingjie ZhaoYang LiuYang LiuYang LiuYu LiuYu LiuYu LiuZhenyi GeZhenyi GeZhenyi GeHaiyan ChenHaiyan ChenHaiyan ChenXianhong ShuXianhong ShuXianhong ShuXianhong ShuFrontiers Media S.A.articlecardiac synchronyphysiological pacingechocardiographyHis bundle pacingleft bundle branch pacingDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiac synchrony physiological pacing echocardiography His bundle pacing left bundle branch pacing Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	cardiac synchrony physiological pacing echocardiography His bundle pacing left bundle branch pacing Diseases of the circulatory (Cardiovascular) system RC666-701 Huilin Xie Huilin Xie Huilin Xie Huilin Xie Xueying Chen Xueying Chen Yanan Wang Yanan Wang Yanan Wang Yufei Cheng Yufei Cheng Yufei Cheng Yingjie Zhao Yingjie Zhao Yingjie Zhao Yang Liu Yang Liu Yang Liu Yu Liu Yu Liu Yu Liu Zhenyi Ge Zhenyi Ge Zhenyi Ge Haiyan Chen Haiyan Chen Haiyan Chen Xianhong Shu Xianhong Shu Xianhong Shu Xianhong Shu Comparison of the Acute Effects of Different Pacing Sites on Cardiac Synchrony and Contraction Using Speckle-Tracking Echocardiography
description	Background: Cardiac pacing in patients with bradyarrhythmia may employ variable pacing sites, which may have different effects on cardiac function. Left bundle branch pacing (LBBP) is a new physiological pacing modality, and the acute outcomes on cardiac mechanical synchrony during LBBP remain uncertain. We evaluated the acute effects of four pacing sites on cardiac synchrony and contraction using speckle-tracking echocardiography, and comparisons among four different pacing sites were rare.Methods: We enrolled 21 patients with atrioventricular block or sick sinus syndrome who each sequentially underwent acute pacing protocols, including right ventricular apical pacing (RVAP), right ventricular outflow tract pacing (RVOP), His bundle pacing (HBP), and left bundle branch pacing (LBBP). Electrocardiograms and echocardiograms were recorded at baseline and during pacing. The interventricular mechanical delay (IVMD), the standard deviation of the times to longitudinal peak strain during 17 segments (PSD), and the Yu index were used to evaluate ventricular mechanical synchrony. Layer-specific strain was computed using two-dimensional speckle tracking technique to provide in-depth details about ventricular synchrony and function.Results: Left ventricular ejection fraction (LVEF) and tricuspid annulus plane systolic excursion (TAPSE) were significantly decreased during RVAP and RVOP but were not significantly different during HBP and LBBP compared with baseline. RVAP and RVOP significantly prolonged QRS duration, whereas HBP and LBBP showed non-significant effects. IVMD and PSD were significantly increased during RVAP but were not significantly different during RVOP, HBP, or LBBP. LBBP resulted in a significant improvement in the IVMD and Yu index compared with RVAP. No significant differences in mechanical synchrony were found between HBP and LBBP.Conclusion: Among these pacing modalities, RVAP has a negative acute impact on cardiac synchrony and contraction. HBP and LBBP best preserve physiological cardiac synchrony and function.
format	article
author	Huilin Xie Huilin Xie Huilin Xie Huilin Xie Xueying Chen Xueying Chen Yanan Wang Yanan Wang Yanan Wang Yufei Cheng Yufei Cheng Yufei Cheng Yingjie Zhao Yingjie Zhao Yingjie Zhao Yang Liu Yang Liu Yang Liu Yu Liu Yu Liu Yu Liu Zhenyi Ge Zhenyi Ge Zhenyi Ge Haiyan Chen Haiyan Chen Haiyan Chen Xianhong Shu Xianhong Shu Xianhong Shu Xianhong Shu
author_facet	Huilin Xie Huilin Xie Huilin Xie Huilin Xie Xueying Chen Xueying Chen Yanan Wang Yanan Wang Yanan Wang Yufei Cheng Yufei Cheng Yufei Cheng Yingjie Zhao Yingjie Zhao Yingjie Zhao Yang Liu Yang Liu Yang Liu Yu Liu Yu Liu Yu Liu Zhenyi Ge Zhenyi Ge Zhenyi Ge Haiyan Chen Haiyan Chen Haiyan Chen Xianhong Shu Xianhong Shu Xianhong Shu Xianhong Shu
author_sort	Huilin Xie
title	Comparison of the Acute Effects of Different Pacing Sites on Cardiac Synchrony and Contraction Using Speckle-Tracking Echocardiography
title_short	Comparison of the Acute Effects of Different Pacing Sites on Cardiac Synchrony and Contraction Using Speckle-Tracking Echocardiography
title_full	Comparison of the Acute Effects of Different Pacing Sites on Cardiac Synchrony and Contraction Using Speckle-Tracking Echocardiography
title_fullStr	Comparison of the Acute Effects of Different Pacing Sites on Cardiac Synchrony and Contraction Using Speckle-Tracking Echocardiography
title_full_unstemmed	Comparison of the Acute Effects of Different Pacing Sites on Cardiac Synchrony and Contraction Using Speckle-Tracking Echocardiography
title_sort	comparison of the acute effects of different pacing sites on cardiac synchrony and contraction using speckle-tracking echocardiography
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/3a033ead99604636819b9ce43c3919bb
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Comparison of the Acute Effects of Different Pacing Sites on Cardiac Synchrony and Contraction Using Speckle-Tracking Echocardiography

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