?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.title=Diastolic+And+Systolic+Right+Ventricular+Dysfunction+Precedes+Left+Ventricular+Dysfunction+In+Patients+Paced+From+Right+Ventricular+Apex+&rft.creator=SK%2C+Dwivedi&rft.creator=Bansal%2C+Sandeep&rft.creator=Puri%2C+Aniket&rft.creator=MK%2C+Makharia&rft.creator=VS%2C+Narain&rft.creator=RK%2C+Saran&rft.creator=M%2C+Hasan&rft.creator=VK%2C+Puri&rft.subject=Indian+Pacing+and+Electrophysiology+Journal&rft.description=Background%3A+Cardiac+dysfunction+after+right+ventricular+(RV)+apical+pacing+is+well+known+but+its+extent%2C+time+frame+of+appearance+and+individual+effect+on+left+ventricular+(LV)%2C+RV+systolic+and+diastolic+parameters+has+not+evaluated+in+a+systematic+fashion.+++++++++%0A%0AMethods%3A+Patients+with+symptomatic+bradycardia+and+ACC-AHA+Class+I+indication+for+permanent+pacemaker+implantation+(PPI)+were+implanted+a+single+chamber+(VVI)+pacemaker.+They+were+followed+prospectively+by+echocardiographic+examination+which+was+done+at+baseline%2C+1+week%2C+1+month+and+6+months+after+implantation.+Parameters+observed+were+chamber+dimensions+(M-line)%2C+chamber+volumes%2C+cardiac+output+(modified+Simpson's+method)%2C+systolic+functions+(ejection+fraction%2C+pre-ejection+period%2C+ejection+time+and+ratio)+and+diastolic+functions(+isovolumic+relaxation+time+%26+deceleration+time)+of+left+and+right+heart.%0A%0AResults%3A+Forty+eight+consecutive+patients+(mean+age+65.6%C2%B111.8+yrs%2C+66.7%25+males%2C+mean+EF+61.82%C2%B110.36%25)+implanted+a+VVI+pacemaker+were+enrolled+in+this+study.+The+first+significant+change+to+appear+in+cardiac+function+after+VVI+pacing+was+in+diastolic+properties+of+RV+as+shown+by+increase+in+RV+isovolumic+relaxation+time+(IVRT)+from+65.89%C2%B115.93+to+76.58%C2%B117.00+ms%2C(p%3C0.001)+at+1week+and+RV+deceleration+time+(DT)+from+133.84%C2%B138.13+to+153.09%C2%B131.41+ms%2C+(p%3D0.02)+at+1+month.+Increase+in+RV+internal+dimension+(RVID)+from+1.26%C2%B10.41+to+1.44%C2%B10.44%2C+(p%3C0.05)+was+also+noticed+at+1+week.+The+LV+diastolic+parameters+were+significantly+altered+after+1+month+with+increase+in+LV-IVRT+from+92.36%C2%B121.47+to+117.24%C2%B127.21ms%2C+(p%3C0.001)+and+increase+in+LV+DT+from+147.56%C2%B131.84+to+189.27%C2%B128.49ms%2C(p%3C0.01).+This+was+followed+by+LV+systolic+abnormality+which+appeared+at+6+months+with+an+increase+in+LVPEP+from+100.33%C2%B114.43+to+118.41%C2%B121.34ms%2C+(p%3C0.001)+and+increase+in+LVPEP%2FLVET+ratio+from+0.34%C2%B10.46+to+0.44%C2%B10.10%2C+(p%3C0.001)%5D.+The+reduction+in+LV+EF+was+manifested+at+6+months+falling+from+61.82%C2%B110.36%25+to52.52%C2%B112.11%25%2C+(p%3C0.05)+without+any+significant+change+in+the+resting+cardiac+output.%0A%0AConclusion%3A+The+present+study+shows+that+dysfunction+of+right+ventricle+is+the+first+abnormality+that+occurs+in+VVI+paced+patients%2C+which+manifests+by+1+week+followed+by+LV+dysfunction+which+starts+appearing+by+1+month+and+the+diastolic+dysfunctions+precede+the+systolic+dysfunction+in+both+ventricles.+%0A&rft.publisher=Indian+Pacing+and+Electrophysiology+Group&rft.contributor=Singh%2C+Balbir&rft.contributor=Lokhandwala%2C+Yash&rft.contributor=Francis%2C+Johnson&rft.contributor=Gupta%2C+Anup&rft.contributor=Ghosh%2C+Joydeep&rft.date=2006-07&rft.type=Journal+(Paginated)&rft.type=PeerReviewed&rft.format=text%2Fhtml&rft.identifier=http%3A%2F%2Fcogprints.org%2F5210%2F1%2Fdwivedi.htm&rft.format=application%2Fpdf&rft.identifier=http%3A%2F%2Fcogprints.org%2F5210%2F2%2Fdwivedi.pdf&rft.identifier=++SK%2C+Dwivedi+and+Bansal%2C+Sandeep+and+Puri%2C+Aniket+and+MK%2C+Makharia+and+VS%2C+Narain+and+RK%2C+Saran+and+M%2C+Hasan+and+VK%2C+Puri++(2006)+Diastolic+And+Systolic+Right+Ventricular+Dysfunction+Precedes+Left+Ventricular+Dysfunction+In+Patients+Paced+From+Right+Ventricular+Apex.++%5BJournal+(Paginated)%5D+++++&rft.relation=http%3A%2F%2Fcogprints.org%2F5210%2F