OBJECTIVE To determine the effect of multisite pacing on left ventricular function. DESIGN Prospective observational study. PATIENTS 18 patients with heart failure with a dilated poorly functioning left ventricle (LV) and left bundle branch block. INTERVENTIONS Pacing for 5 minutes in random order at the right ventricle (RV) apex, RV outflow tract, mid posterolateral LV, RV apex and LV si...

Figure 1 A: Baseline electrocardiogram (ECG) during biventricular pacing at 60 beats per minute showing an underlying left atrial flutter and bigeminy. The premature ventricular complexes have the same morphology and a coupling interval of 630 ms, indicated by the blue rectangle. B: Baseline ECG, after reprograming the lower pacing rate at 30 beats per minute, showing poor residual atrioventric...

BACKGROUND Biventricular pacing in heart failure (HF) improves survival, relieves symptoms, and attenuates left ventricular (LV) remodeling. However, little is known about biventricular pacing in HF patients with atrioventricular block because they are typically excluded from biventricular trials. METHODS AND RESULTS The Biventricular versus Right Ventricular Pacing in Heart Failure Patients ...

Biventricular pacing or resynchronisation therapy is a non-pharmacological therapy for patients with chronic heart failure. Since being originally described in 1994, biventricular pacing has become a subject of intense interest and investigation. This review analyses the results reported in observational series and randomised trials, and seeks to answer two questions. If it works, why does it w...

BACKGROUND The increase in global coronary flow seen with conventional biventricular pacing is mediated by an increase in the dominant backward expansion wave (BEW). Little is known about the determinants of flow in the left-sided epicardial coronary arteries beyond this or the effect of endocardial pacing stimulation on coronary physiology. METHODS AND RESULTS Eleven patients with a chronica...

Prolong QT Interval and Increase Transmural Dispersion of Repolarization To the Editor: The recent article by Medina-Ravell et al1 addresses a potentially harmful effect of cardiac resynchronization therapy on ventricular repolarization. The authors found that single epicardial and biventricular pacing in patients with congestive heart failure increased the QT interval and the transmural disper...

BACKGROUND AND OBJECTIVES Recent data suggest that biventricular pacing may play an important role in treating advanced heart failure in the presence of a significant interventricular and/or intraventricular conduction disorder by correcting cardiac dysynchrony. In this article, we review the initial technical and clinical experience with cardiac resynchronization therapy in an electrophysiolog...

In recent years there has been a growing interest in using cardiac pacing as additive treatment in severe heart failure. It is estimated that 30% of patients with severe heart failure have intraventricular conduction disturbances mechanically characterised by a discoordinate ventricular contraction pattern and wide QRS complexes. 1 Multisite biven-tricular pacing, which restores the synchronisa...

We present a case of surgical implantation of biventricular epicardial pacing leads and a defibrillating patch via lower half mini sternotomy. Although median sternotomy is routinely used for this purpose, lower half mini sternotomy could provide the surgeon with the same surgical field exposure and a faster post operative recovery.