Physiology of biventricular pacing

Kenneth C. Bilchick, Robert H. Helm, David A Kass

Research output: Contribution to journalArticle

Abstract

Biventricular pacing (cardiac resynchronization therapy [CRT]) has been shown to be a very effective therapy for patients with heart failure and dyssynchrony, with improved survival now shown in a recent trial. Electrical dyssynchrony, usually quantified by the duration of the QRS complex, is distinct from mechanical dyssynchrony. Intraventricular mechanical dyssynchrony is most commonly manifest by decreased septal work with concomitant early lateral wall prestretch and subsequent inefficient late contraction. Intraventricular dyssynchrony appears to be more predictive of response to CRT than interventricular dyssynchrony. Mechanical left ventricular dyssynchrony also is associated with regional molecular derangements in connexin-43, stress response kinases, and tumor necrosis factor-α. These molecular derangements may lead to abnormalities in conduction velocity and action potential duration, which may predispose to ventricular arrhythmia. Biventricular pacing corrects abnormal regional wall stresses and results in electrical, mechanical, and molecular left ventricular remodeling.

Original languageEnglish (US)
Pages (from-to)358-365
Number of pages8
JournalCurrent Cardiology Reports
Volume9
Issue number5
DOIs
StatePublished - Sep 2007

Fingerprint

Cardiac Resynchronization Therapy
Connexin 43
Ventricular Remodeling
Action Potentials
Cardiac Arrhythmias
Phosphotransferases
Heart Failure
Tumor Necrosis Factor-alpha
Survival
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Physiology of biventricular pacing. / Bilchick, Kenneth C.; Helm, Robert H.; Kass, David A.

In: Current Cardiology Reports, Vol. 9, No. 5, 09.2007, p. 358-365.

Research output: Contribution to journalArticle

Bilchick, Kenneth C. ; Helm, Robert H. ; Kass, David A. / Physiology of biventricular pacing. In: Current Cardiology Reports. 2007 ; Vol. 9, No. 5. pp. 358-365.
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