Effect Of Right Ventricular Septal Pacing And Right Ventricular Apex Pacing On Cardiac Hemodynamics

Objective:①By comparing the QRS duration, Left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter (LVEDD), stroke volume (SV) andmitral early diastolic maximum blood flow velocity (EV) are the cardiac functionindexes. By comparing them to evaluate the cardiac hemodynamics with differentventricular pacing site.②By comparing the electrode parameters and surgicalcomplications to assessing the feasibility of RVS pacing. Comprehensive Evaluationof right ventricular apical pacing and right ventricular septal pacing on cardiachemodynamics.Methods:28patients with dual-chamber pacemaker implanted for the first time,the average age of them are65.32±11.67years. They were divided into RVS groupand RVA group at random. Observed the ventricular electrodes parameters change(Including pacing threshold value, sensing threshold value, impedance.) and surgicalcomplications to evaluate the the feasibility of RVS pacing. The ventricularsynchrony was evaluate by QRS duration between two groups. Differences throughchanges before and after pacing evaluation of the left ventricular ejectionfraction(LVEF), left ventricular end-diastolic dimension(LVEDD), strokevolume(SV), E peak(E) pacing site on cardiac function.Results:There were no significant differences between RVA ana RVS group ofelectrode threshold changes and complications. To compared with preoperative, thereis a statistically significant difference in the two sets of QRS duration afterpacing(P<0.01), the mean QRS duration was169.29±19.73ms for RVA pacing and135.29±29.56ms for RVS pacing. The LVEDD and SV after pacing of RVA groupare50.00±3.82%and58.00±12.82ml, of RVS group are51.64±2.59%and 64.00±16.30ml, it is a statistically significant difference(P<0.05). The degree ofLVEDD and SV reduction in RVS group was significantly less than the RVA group(2.64±2.10vs5.78±3.02%,2.07±2.37ml of vs6.71±4.97ml)(P<0.05).Conclusion:①R VS pacing is safe and feasible;②RVS pacing and RVApacing are not fully consistent with physiologic pacing, but the adverse effects of theRVS pacing on hemodynamics is less. RVS is a more ideal than RVA ventricularpacing site.