Ventricular pacing with premature excitation for treatment of hypertensive-cardiac hypertrophy with cavity-obliteration

David A Kass, Chen Huan Chen, Maurice W. Talbot, Carlos E. Rochitte, Joao Lima, Ronald D Berger, Hugh Calkins

Research output: Contribution to journalArticle

Abstract

Background - Hypertensive left ventricular hypertrophy with supranormal systolic ejection and distal cavity obliteration (HHCO) can result in debilitating exertional fatigue and dyspnea. Dual-chamber pacing with ventricular preactivation generates discoordinate contraction, which can limit cavity obliteration and thereby increase potential ejection reserve. Accordingly, we hypothesized that pacing may improve exercise tolerance long- term in this syndrome. Methods and Results - Dual-chamber pacemakers were implanted in 9 patients with exertional dyspnea caused by HHCO. Intrinsic atrial rate was sensed, and ventricular preactivation was achieved by shortening the atrial-ventricular delay. Pacing was on or off for successive 3-month periods (randomized, double-blind, crossover design), followed by 6 additional pacing-on months. Metabolic exercise testing, quality-of-life assessment, and rest and dobutamine-stress echocardiographic/Doppler data were obtained. After 3 months of pacing-on, exercise duration rose from 324±133 to 588±238 s (mean±SD; P=0.001, with 7 of 9 patients improving ≥30%), and maximal oxygen consumption increased from 13.6±2.9 to 16.7±3.3 mL of O2·min-1·kg-1 (P

Original languageEnglish (US)
Pages (from-to)807-812
Number of pages6
JournalCirculation
Volume100
Issue number8
StatePublished - Aug 24 1999

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Cardiomegaly
Dyspnea
Exercise
Dobutamine
Exercise Tolerance
Left Ventricular Hypertrophy
Oxygen Consumption
Cross-Over Studies
Fatigue
Quality of Life
Therapeutics

Keywords

  • Exercise
  • Heart failure
  • Hypertension
  • Hypertrophy
  • Pacing

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Ventricular pacing with premature excitation for treatment of hypertensive-cardiac hypertrophy with cavity-obliteration. / Kass, David A; Chen, Chen Huan; Talbot, Maurice W.; Rochitte, Carlos E.; Lima, Joao; Berger, Ronald D; Calkins, Hugh.

In: Circulation, Vol. 100, No. 8, 24.08.1999, p. 807-812.

Research output: Contribution to journalArticle

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AU - Lima, Joao

AU - Berger, Ronald D

AU - Calkins, Hugh

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