Effects of Biventricular Pacing on Cardiac Performance and Clinical Status in Patients with Advanced Congestive Heart Failure

Biventricular pacing has been suggested as an effective therapeutic method in patients with advanced congestive heart fa ilure (CHF) and intraventricular conduction delay. We aimed to evaluate effects on cardiac perforinance and elinical status of biventricular pacing in patients with CHF and intraventricular conduction delay. Patients with advanced CHF (NYHA class III-IV) and intraventricular conduction delay were selected for biventricular pacemaker implantation. NYHA classification, exercise test with Naughton protocol, quality of life score and echocardiographic measurements (left ventricular dimensions, ejection fraction, dP/dt, diastolic fill ing time, the duration of mitral regu rgitation and QRS-aortic ejection interval) before implantation and at the end of the follow-up were compared. The long-term effects (lı±8 months) of biventricular pacing were evaluated in 23 patients. When basa! and at the end of the foll ow-up values were compared, mean NYHA class (3,6±0,5 1 2,6±l, ı , p=O,OOO ı ), mean exercise capacity (1,9±1 ,4 1 3,5±2,2 MET, p= O,OO ı ) and mean quality of life score (65±15 1 42±28, p= 0,00 ı) w ere improved. The mean LV dP/dt Türk Kardiyol Dem Arş I.UUI; LY: (484±150 1 744±312 mmHg/see, p= 0,007), mean ejection fraction (%25±8 1 %32±8, p= 0,004), mean diastolic filling time (324±111 1 402±78 msec, p= 0,004) increased and, mean QRS duration (175±24 1 149±16 msec, p= 0,0001), mean QRS-aortic ejection interval (163±36 1 135±34 msec, p= 0,005), mean LV end-systolic diameter (62±8 1 56±8 mm, p= 0,02) decreased by permanent biventricular pacing. Permanent biventricu lar pacing is a treatment method that may improve cardiac performance and elinical status in patients with advanced CHF and intraventricular conduction delay.