Copyright © 2003 by the European Society of Cardiology.
Review article
Pacing in heart failure: patient and pacing mode selection
Royal Brompton Hospital, London, UK
* Corresponding author. Dr T.V. Salukhe, Royal Brompton Hospital, Cardiac Medicine, Sydney Street, London SW3 6NP, UK. +44-207-352-8121; fax.:+44-207-351-8733
E-mail address: salukhe@aol.com
Received 8 October 2002; revised 18 February 2003; accepted 26 February 2003
| The first 150 words of the full text of this article appear below. |
1. Introduction
Pharmacological therapy in the management of heart failure has been proven and is well established. In the last decade ACE inhibitors,1,2 beta-blockers,3,4 spironolactone5 and digoxin6 have contributed to a reduction in mortality of nearly 50%, a reduced frequency of hospital admissions and improvement in quality of life.7–9 However, congestive heart failure still endures a high overall annual mortality of about 10%, with a 50% incidence of sudden death. Furthermore, many patients remain symptomatic and have a poor functional status (classified as NHYA III and IV) despite optimal medical therapy. It is in such patients in whom cardiac haemodynamics may be improved through appropriate pacing modalities with reasonable expectation of a better functional status.
Conventional dual-chamber and bi-ventricular pacing have shown promise in the management of heart failure. In this article we will present the evidence in support of both modalities, but, moreover, emphasize the importance of appropriate patient and pacing
2. Search strategy and article selection criteria
3. Conventional Dual Chamber (DDD) Pacing
4. LV filling dynamics in DCM
5. Patient selection for DDD pacing in DCM
6. Ventricular asynchrony
7. Bi-ventricular pacing — acute haemodynamic studies
8. Bi-ventricular pacing — clinical studies
9. Biventricular pacing — developmental directions
9.1. Patient selection
9.2. Lead placement
9.3. Atrial fibrillation
9.4. Mortality and Economy
10. Summary
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