Influence of selective stimulation of the right ventricle on electric and mechanical myocardial disynchrony

Relevance. Prolonged apical stimulation of the right ventricle can lead to the development of interventricular and intraventricular dyssynchrony. Selective (alternative) stimulation of various parts of the interventricular septum due to a more physiological propagation of the excitation wave makes it possible to prevent the deterioration of the mechanical function of the myocardium associated with constant pacing.Purpose. To study the dynamics of indicators of electrical and mechanical ventricular dyssynchrony in the traditional (apical) and alternative with the installation of a right ventricular electrode in the interventricular septum or the outlet tract of the right ventricle in patients with constant pacing in the early and late postoperative period.Materials and methods. Were included 73 patients (mean age 61.0 ± 2.5 years) with indications for continuous cardiac pacing without signs of heart failure above 2 FC according to NYHA and previous Q-forming myocardial infarction. Patients of group 1 (n = 39) were implanted with a pacing ventricular electrode in the middle section of the interventricular septum (subgroup 1A, n = 25) or in the outflow tract of the right ventricle (subgroup 1B, n = 14). The control group 2 included 34 patients with electrode implantation in the apex of the right ventricle.Results. The time of pre-ejection from the right and left ventricles before and after implantation did not differ in group 1 and significantly differed in group 2 (25 ± 3 ms and 50 ± 6 ms, p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }