Copyright © 2001 by the European Society of Cardiology.
Effects of asynchronous ventricular activation on myocardial adrenergic innervation in patients with permanent dual-chamber pacemakers. An I123-metaiodobenzylguanidine cardiac scintigraphic study
a Cardiology Department, University Hospital of Heraklion, Crete, Greece
b Department of Nuclear Medicine, University Hospital of Heraklion, Crete, Greece
revised September 26, 2000; accepted October 4, 2000
Abstract
Aims To evaluate myocardial sympathetic innervation abnormalities in patients with DDD pacemakers for complete heart block.
Methods We studied 39 patients, chronically paced in DDD mode because of complete atrioventricular block. Twenty-three healthy individuals served as a control group. All patients underwent planar and single-photon emission computed tomography (SPECT) myocardial imaging 4h after intravenous infusion of 185MBq I123-MIBG. The heart to mediastinum ratio was calculated to quantify cardiac I123-MIBG accumulation, while the SPECT study was performed to investigate the regional distribution of adrenergic innervation. All patients underwent a SPECT thallium201myocardial study during the same week as the I123-MIBG study.
Results The heart to mediastinum ratio was significantly smaller in paced patients than in the controls (P<0·001). 89·7% of paced patients had regional abnormalities of I123-MIBG uptake, mainly in the inferior (92·3%) and apical (38·5%) wall. 46·2% of paced patients had regional perfusion defects, also mainly in the inferior (46·2%) and apical (10·3%) wall. Neither the I123-MIBG abnormalities nor the perfusion defects were related to the duration of pacing.
Conclusions Stimulation from the apex of the right ventricle leads to regional disturbances of the adrenergic innervation of the left ventricular myocardium, as assessed by I123-MIBG activity.
Key Words: Pacing, myocardial scintigraphy, adrenergic innervation
f1 Correspondence: Prof. P. E. Vardas, MD, PhD (London), FESC, FACC, Cardiology Department, University Hospital of Heraklion, P.O. Box 1352, Stavrakia, Heraklion, Crete, Greece.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E. N. Simantirakis, E. G. Arkolaki, S. I. Chrysostomakis, and P. E. Vardas Biventricular pacing in paced patients with normal hearts Europace, November 1, 2009; 11(suppl_5): v77 - v81. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Europace, October 1, 2007; 9(10): 959 - 998. [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Eur. Heart J., September 2, 2007; 28(18): 2256 - 2295. [Full Text] [PDF]
|
|
|
|
|
|
E. de Teresa, J. J. Gomez-Doblas, G. Lamas, J. Alzueta, I. Fernandez-Lozano, E. Cobo, X. Navarro, F. Navarro-Lopez, and M. Stockburger Preventing ventricular dysfunction in pacemaker patients without advanced heart failure: rationale and design of the PREVENT-HF study Europace, June 1, 2007; 9(6): 442 - 446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Dilaveris, A. Pantazis, G. Giannopoulos, A. Synetos, J. Gialafos, and C. Stefanadis Upgrade to biventricular pacing in patients with pacing-induced heart failure: can resynchronization do the trick? Europace, January 1, 2006; 8(5): 352 - 357. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Preumont, J.-L. Jansens, G. Berkenboom, P. van de Borne, E. Stoupel, and S. Goldman Effects of right ventricular pacing on regional myocardial glucose metabolism Europace, January 1, 2005; 7(6): 584 - 591. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. N. Simantirakis, G. E. Kochiadakis, K. E. Vardakis, N. E. Igoumenidis, S. I. Chrysostomakis, and P. E. Vardas Left Ventricular Mechanics and Myocardial Blood Flow Following Restoration of Normal Activation Sequence in Paced Patients With Long-term Right Ventricular Apical Stimulation Chest, July 1, 2003; 124(1): 233 - 241. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-F. Tse, C. Yu, K.-K. Wong, V. Tsang, Y.-L. Leung, W.-Y. Ho, and C.-P. Lau Functional abnormalities in patients with permanent right ventricular pacing: The effect of sites of electrical stimulation J. Am. Coll. Cardiol., October 16, 2002; 40(8): 1451 - 1458. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M E Marketou, E N Simantirakis, V K Prassopoulos, S I Chrysostomakis, A A Velidaki, N S Karkavitsas, and P E Vardas Assessment of myocardial adrenergic innervation in patients with sick sinus syndrome: effect of asynchronous ventricular activation from ventricular apical stimulation Heart, September 1, 2002; 88(3): 255 - 259. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E.N. Simantirakis, S.I. Chrysostomakis, M.E. Marketou, G.E. Kochiadakis, K.E. Vardakis, H.E. Mavrakis, and P. Vardas Atrial and ventricular refractoriness in paced patients; circadian variation and its relationship to autonomic nervous system activity Eur. Heart J., December 1, 2001; 22(23): 2192 - 2200. [Abstract] [PDF]
|
|