A Change of BNP Value and QRS Duration by Ventricular Pacing

概要

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Background: Although a pacemaker therapy is useful treatment in atrioventricular block (AVB) patients, ventricular pacing may have a bad influence in cardiac function. The purpose of this study is considering the difference of QRS duration in sinus rhythm and in ventricular pacing, and the difference of ejection fraction (EF). Methods: The pacemaker operation was enforced to 314 patients with AVB. In 61 cases among the 314 patients, the QRS duration prolonged by ventricular pacing. In this 61 cases, the difference of the BNP values were compared between cardiac dysfunction group (EF<50%) and good cardiac function group (EF>50%). Results: The cardiac dysfunction group is consist of 17 patients (28%). In this group, 14 patients (83%) showed QRS prolongation more than 20 ms after ventricular pacing, and all these patients' BNP value elevated significantly. The BNP values did not change in the cardiac dysfunction group with no prolongation of QRS duration after ventricular pacing. In the good cardiac function group (EF>50%), the BNP values did not change significantly after ventricular pacing regardless of QRS prolongation. Conclusions: In patients with cardiac dysfunction, it was suggested that a prolongation of the QRS complex by ventricular pacing would worsen BNP values and cardiac function.