Publication date: Available online 1 December 2018
Source: Ultrasound in Medicine & Biology
Author(s): Jiaojiao Tang, Silin Chen, Lie Liu, Hongtao Liao, Xianzhang Zhan, Shulin Wu, Yuanhong Liang, Oudi Chen, Chunying Lin, Qianhuan Zhang, Huiqiang Wei, Dongli Chen
Abstract
The study described here aimed to evaluate left ventricular (LV) systolic mechanical synchronization during permanent selective His bundle pacing (SHBP) using 3-D speckle-tracking echocardiography post-operatively and 6 mo after pacemaker implantation in 62 patients randomly assigned to SHBP (n = 32) or right ventricular apical pacing (RVAP, n = 30). A standard apex four-chamber view was exposed and was transformed into full-volume mode under 3-D echocardiography. Three-dimensional speckle-tracking echocardiography was analyzed offline. The primary endpoint was LV mechanical synchronization post-operatively and during the 6-mo follow-up. Significant LV dyssynchrony was detected while evaluating the maximum time difference and standard deviation of 16-segment systolic time to peak 3-D strain at 1 wk and 6 mo. The pacing thresholds were significantly higher in the SHBP than in the RVAP group throughout follow-up. The R-wave amplitude was significantly lower in the SHBP group than with RVAP. The pacing parameters during SHBP were as stable as during conventional RVAP during the mid-term follow-up. In conclusion, 3-D speckle-tracking echocardiography is feasible and provides a more convenient method for evaluating LV synchrony.
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