Objective To compare the effects of biventricular synchronous pacing with different pacing site on coronary Blood flow (CBF), myocardial oxygen consumption (MVO2) and cardiac work efficiency (CWE).
Methods RA-cHisB and RA-RVA sequential pacing, RVA-LVPL and cHisB-LVPL pacing, RA-RVA-LVPL and RA-cHisB-LVPL pacing were randomly performed in 14 dogs with general-anaesthetised, opened chest and artificial-ventilation. SNR was as self-control. Every pacing mode was to capture SNR for 20 min with a recovery of physiologic parameters for 10 min, and then shift another pacing mode in turn. CFB and CO were measured by a electromagnetic flowmeter. Blood sample were respectively collected from the catheters in left ventricle and coronary sinus for getting the arterial O2 saturation (SaO2), coronary sinus O2 saturation (ScsO2) and Hgb.
Results No significant difference in CBF among the RA-cHisB-LVPL, RA-RVA-LVPL and RA-cHisB pacing were found. CBF in RA-RVA pacing was decreased than that in RA-cHisB-LVPL, RA-RVA-LVPL and RA-cHisB pacing. MVO2 among the all groups had no significant changes compared with each other. CO of RA-cHisB, RVA-LVPL and cHisB-LVPL pacing were increased as compared with that in RA-RVA pacing (p<0.01). CO in cHisB-LVPL pacing was increased by 6.7% than that in RVA-LVPL pacing. CO in RA-cHisB pacing was increased by 8.7% than that in RA-RVA pacing. CO in RA-RVA-LVPL pacing was increased as compared with that in RA-cHisB and cHisB-LVPL pacing, respectively. CO in RA-cHisB-LVPL pacing was increased than that in RA-RVA-LVPL pacing. The changes of CWE were similar to that of CO among all pacing groups. CWE in RA-cHisB-LVPL pacing was significantly enhanced as compared with that in RA-cHisB and RA-RVA-LVPL pacing. Conclusions RA-cHisB dual chamber, cHisB-LVPL biventricular and RA-cHisB-LVPV triple-chamber pacing might significantly increase CBF and CWE without the increment of MVO2.
Conclusion The biventricular synchronous pacing have the beneficial effects on maintaining the balance between myocardial oxygen supply and consumption and increasing CWE by enhancing the cardiac ejection performance.
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