Assessing Reduction in Left Ventricular Activation Time with His-Bundle Pacing Utilizing a Novel Left Lateral Accessory Pathway Model
|Tahmeed Contractor1*, Gopi Krishna Panicker2, Behzad Pavri3 and Yash Lokhandwala4|
|1Division of Internal Medicine, Michigan State University, East Lansing, Michigan, USA|
|2Quintiles Cardiac Safety Services, Mumbai, Maharashtra, India|
|3Associate Professor of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA|
|4Holy Family Hospital, Mumbai, Maharashtra, Indi|
|Corresponding Author :||Tahmeed Contractor
B 301 Clinical Center, 138 Service Road
East Lansing, MI 48824, USA
E-mail: [email protected]
|Received: December 09, 2010; Accepted: February 09, 2011; Published: February 11, 2011|
|Citation: Contractor T, Panicker GK, Pavri B, Lokhandwala Y (2011) Assessing Reduction in Left Ventricular Activation Time with His-Bundle Pacing Utilizing a Novel Left Lateral Accessory Pathway Model. J Clinic Experiment Cardiol 2:122. doi:10.4172/2155-9880.1000122|
|Copyright: © 2011 Contractor T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Aims: Right ventricular pacing results in a prolongation of the left ventricular activation time, which is attributed to delayed activation of the left ventricular lateral wall. Left ventricular activation time has only been indirectly recorded in human subjects. The objective of this study was to model to directly measure left ventricular activation time utilizing a novel left lateral accessory pathway model and assess its shortening with His-bundle pacing, a proposed physiological pacing modality.
Materials and Methods: Consecutive adults with a pure retrograde conducting left lateral accessory pathway and both His-bundle as well as isolated myocardial capture were included. The interval from the pacing stimulus to the atrial activation in the left lateral region was measured as the left ventricular activation time, which was then compared during His-bundle versus myocardial pacing using paired t-test for means.
Results: A total of 50 subjects were found eligible for inclusion (Males=27; mean age=39±14). His-bundle pacing resulted in a significant reduction of left ventricular activation time when compared to myocardial pacing (122±15 vs 152±17; p<0.001).
Conclusion: Left ventricular activation time can be directly recorded in human subjects utilizing a pure-retrograde left lateral accessory pathway model and is significantly reduced with His-bundle pacing.