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Zhang Y, Jia Y, Liu J, Du R. A systematic review and Bayesian network meta-analysis comparing left bundle branch pacing, his bundle branch pacing, and right ventricular pacing for atrioventricular block. Front Cardiovasc Med 2022; 9:939850. [PMID: 36386361 PMCID: PMC9640391 DOI: 10.3389/fcvm.2022.939850] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/03/2022] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Although right ventricular pacing (RVP) is recommended by most of the guidelines for atrioventricular block, it can cause electrical and mechanical desynchrony, impair left ventricular function, and increase the risk of atrial fibrillation. Recently, the His-Purkinje system pacing, including His bundle pacing (HBP) and left bundle branch pacing (LBBP), has emerged as a physiological pacing modality. However, few studies have compared their efficacy and safety in atrioventricular block (AVB). METHODS AND RESULTS The PubMed, Web of Science, Cochrane Library, and ScienceDirect databases were searched for observational studies and randomized trials of patients with atrioventricular block requiring permanent pacing, from database inception until 10 January 2022. The primary outcomes were complications and heart failure hospitalization. The secondary outcomes included changes in left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD), pacing parameters, procedure duration, and success rate. After extracting the data at baseline and the longest follow-up duration available, a pairwise meta-analysis and a Bayesian random-effects network meta-analysis were performed. Odds ratios (ORs) with 95% confidence intervals (CIs) or 95% credible intervals (CrIs) were calculated for dichotomous outcomes, whereas mean differences (MDs) with 95% CIs or 95% CrIs were calculated for continuous outcomes. Seven studies and 1,069 patients were included. Overall, 43.4% underwent LBBP, 33.5% HBP, and 23.1% RVP. Compared with RVP, LBBP and HBP were associated with a shorter paced QRS duration and a more preserved LVEF. HBP significantly increased the pacing threshold and reduced the R-wave amplitude. There was no difference in the risk of complications or the implant success rate. The pacing threshold remained stable during follow-up for the three pacing modalities. The pacing impedance was significantly reduced in HBP, while a numerical but non-significant pacing impedance decrease was observed in both LBBP and RVP. LBBP was associated with an increased R-wave amplitude during follow-up. CONCLUSION In this systematic review and network meta-analysis, HBP and LBBP were superior to RVP in paced QRS duration and preservation of LVEF for patients with atrioventricular block. LBBP was associated with a lower pacing threshold and a greater R-wave amplitude than HBP. However, the stability of the pacing output of LBBP may be a concern. Further investigation of the long-term efficacy in left ventricular function and the risk of heart failure hospitalization is needed. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=315046], identifier [CRD42022315046].
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Affiliation(s)
- Yue Zhang
- Graduate School of Hebei Medical University, Shijiazhuang, China
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, China
| | - Yuan Jia
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, China
| | - Jia Liu
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, China
| | - Rongpin Du
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, China
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Huang J, Guo L, Zhang W, Li R, He B. Left bundle branch potential predicts better electrical synchrony in bradycardia patients receiving left bundle branch pacing. BMC Cardiovasc Disord 2022; 22:376. [PMID: 35986250 PMCID: PMC9389707 DOI: 10.1186/s12872-022-02812-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background Left bundle branch pacing (LBBP) is a novel physiological pacing technology. We aim to explore the relation between LBB potential (LBB Po) and left ventricular (LV) electrical/mechanical synchrony in bradycardia patients without heart failure (HF) receiving LBBP. Methods A total of 62 patients undergoing LBBP were categorized by LBB Po: the LBB Po positive (+) group and the LBB Po negative (−) group. The perioperative electrocardiographic and echocardiography parameters related to cardiac synchrony were analyzed. Results There were 42 (67.74%) patients in the LBB Po (+) group and 20 patients in the LBB Po (−) group. Paced QRS duration (113.50 ± 17.65 ms vs. 123.40 ± 13.18 ms, P = 0.031) and stimulus left ventricular activation time (71.76 ± 3.53 ms vs. 74.45 ± 3.12 ms, P = 0.005) were shorter in the LBB Po (+) group than in the LBB Po (−) group. No significant differences in the LV mechanical synchrony (Ts-SD-12, 36.55 ± 19.76 vs. 39.95 ± 16.04, P = 0.505; PSD, 51.14 ± 17.69 vs. 45.65 ± 10.55, P = 0.205) between the two groups. There was not statistically difference in ventricular lead parameters measured intraoperative between the two groups. Compared with the LBB Po (−) group, the LBB Po (+) group showed a dramatically higher total procedure duration time (93.52 ± 9.18 min vs. 86.25 ± 10.54 min, p = 0.007) and fluoroscopy time for ventricle lead implantation (18.95 ± 3.43 min vs. 14.00 ± 3.16 min, p < 0.001). Conclusions The appearance of LBB Po may suggest better electrical synchrony during LBBP, but similar in LV mechanical synchrony. However, the total operation duration and fluoroscopy time of ventricular lead implantation in the LBB Po (+) group were longer. Therefore, it may be unnecessary to deliberately recognize the LBB Po when it is difficult to detect LBB Po and meet the LBBP criterion.
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Dawood M, Elsharkawy E, Abdel-Hay MA, Nawar M. Predictors of pacing induced left ventricular dysfunction and cardiomyopathy assessed by three-dimensional echocardiography and speckle tracking strain. Egypt Heart J 2021; 73:10. [PMID: 33496897 PMCID: PMC7838225 DOI: 10.1186/s43044-021-00136-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background Long-term RV pacing leads to ventricular dyssynchrony, in the form of LBBB-like morphology, with subsequent detrimental effects on LV structure and function. Three-dimensional echocardiography allowed early detection of volumetric changes associated with PICMP and provided more accurate assessment of mechanical dyssynchrony. Speckle tracking strain is able to identify LV dysfunction even before any reduction in LVEF. Our aim was to study pacing effects on LV function and hemodynamics using 3D echo and speckle tracking strain. Results This was a prospective study of 175 consecutive patients without structural heart disease (LVEF > 50%) presented for permanent pacing. Full-volume 3D echocardiography done before implantation, 1 week, and 6 months together with GLS. Patients were followed for 6 months to detect incidence of PIVD (defined as reduction in LVEF > 10% but still above 50%) and PICMP (defined as decrease in LVEF by 10% from baseline in absence of other known causes of cardiomyopathy resulting in EF< 50%). PIVD and PICMP predictors and risk factors were analyzed. Only 50 patients met study criteria. Twenty-five (50%) patients developed LV systolic dysfunction; of these, 19 (38%) developed PIVD and 6 (12%) developed PICMP. Pre-implantation GLS was significantly lower in the 6 patients who subsequently developed PICMP, compared to those who developed PIVD and the preserved EF group (mean GLS − 15.50 vs. − 21.0, − 20.0 respectively; p = 0.005, 0.033, respectively). At 1 week, GLS was significantly lower in the 25 patients who subsequently developed PIVD, compared to those who did not (GLS − 13.0 vs. − 18.0, respectively; p = 0.002). A reduction of baseline GLS by 15% or more at 1 week was associated with the development of PIVD and PICMP (p = < 0.001). A wider native QRS complex was associated with PIVD and PICMP (p = 0.008, 0.018, respectively). The other predictors were found non-significant. Conclusion PICMP may be more common than previously reported and it may occur shortly after implantation. Pre-implantation GLS is a sensitive parameter for PICMP. One-week GLS, pre-implantation QRS complex width are early predictors for PICMP and PIVD before any reduction in EF. Supplementary Information The online version contains supplementary material available at 10.1186/s43044-021-00136-x.
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Affiliation(s)
- Moustafa Dawood
- Cardiology and Angiology Department, Alexandria Faculty of Medicine, Alexandria, 21568, Egypt.
| | - Eman Elsharkawy
- Cardiology and Angiology Department, Alexandria Faculty of Medicine, Alexandria, 21568, Egypt
| | - Mohamed Ayman Abdel-Hay
- Cardiology and Angiology Department, Alexandria Faculty of Medicine, Alexandria, 21568, Egypt
| | - Moustafa Nawar
- Cardiology and Angiology Department, Alexandria Faculty of Medicine, Alexandria, 21568, Egypt
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Hu Y, Li H, Gu M, Hua W, Niu H, Zhang N, Liu X, Chen X, Hou C, Zhou X, Zhang S. Comparison between his-bundle pacing and left bundle branch pacing in patients with atrioventricular block. J Interv Card Electrophysiol 2020; 62:63-73. [PMID: 32954478 DOI: 10.1007/s10840-020-00869-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pacing the cardiac conduction system has been explored in patients with conduction system disease, but comprehensive comparisons between different pacing modalities are not well investigated. OBJECTIVE To compare pacing characteristics and ventricular synchrony between His-bundle pacing (HBP) and left bundle branch pacing (LBBP) in patients with atrioventricular block (AVB). METHODS Fifty pacemaker-indicated patients with AVB were enrolled. Twenty-five patients underwent HBP, and another 25 patients underwent LBBP. Success rate, procedural and fluoroscopy duration, pacing parameters, and echocardiographic data were perioperatively assessed and at 3-month follow-up. RESULTS HBP was successful in 19 of 25 (76.0%) patients, whereas LBBP was successful in 22 of 25 (88.0%) patients. Compared with HBP, LBBP capture threshold was significantly lower (0.76 ± 0.25 V/0.4 ms vs. 1.27 ± 0.61 V/1.0 ms, P = 0.003) and R-wave amplitude was significantly higher with LBBP (11.7 ± 6.6 vs. 4.9 ± 2.4 mV, P < 0.001) at implant. The mean procedural time (74.3 ± 17.8 vs. 63.2 ± 12.3 min, P = 0.029) and fluoroscopy duration (10.3 ± 4.5 vs. 6.8 ± 2.2 min, P = 0.005) were significantly longer in the HBP group compared to LBBP. At 3-month follow-up, pacing capture threshold remained more stable in LBBP than in HBP group while left ventricular synchrony was similar between both groups. CONCLUSION Despite similar impact on ventricular synchrony compared with HBP, LBBP featured a significantly lower pacing capture threshold, higher R-wave amplitude, and less time to achieve similar success rate in patients with AVB. These findings indicate LBBP as a physiological pacing strategy for AVB patients.
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Affiliation(s)
- Yiran Hu
- Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring West Road, Beijing, 100070, China.,The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Hui Li
- Department of Ultrasound, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China
| | - Min Gu
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Wei Hua
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, 100037, China.
| | - Hongxia Niu
- The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Nixiao Zhang
- Department of Ultrasound, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China
| | - Xi Liu
- Department of Ultrasound, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China
| | - Xuhua Chen
- Department of Ultrasound, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China
| | - Cuihong Hou
- Department of Ultrasound, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China
| | - Xiaohong Zhou
- Cardiac Rhythm and Heart Failure, Medtronic plc, Mounds View, MN, 55112, USA
| | - Shu Zhang
- Department of Ultrasound, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China
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Cai B, Huang X, Li L, Guo J, Chen S, Meng F, Wang H, Lin B, Su M. Evaluation of cardiac synchrony in left bundle branch pacing: Insights from echocardiographic research. J Cardiovasc Electrophysiol 2020; 31:560-569. [PMID: 31919928 PMCID: PMC7027438 DOI: 10.1111/jce.14342] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/30/2019] [Accepted: 01/06/2020] [Indexed: 12/22/2022]
Abstract
AIM The aim of this study is to assess if left bundle branch pacing (LBBP) can preserve physiological cardiac synchrony and deliver favorable hemodynamic effects. METHODS Consecutive patients undergoing dual chamber pacemaker implantation for sick sinus syndrome (SSS) and a normal cardiac function with a narrow QRS complex were recruited for the study. Electrocardiogram and echocardiographic examinations were performed during ventricular pacing-on and native-conduction modes. The QRS duration (QRSd), systolic dyssynchrony index (SDI), and the standard deviation of time-to-peak contraction velocity in left ventricular (LV) 12 segments (Tsd-12-LV) were measured to evaluate LV synchrony. The stroke volume (SV) and the degree of atrioventricular valvular regurgitation were also assessed. RESULTS A total of 40 patients underwent LBBP, while another 38 patients underwent right ventricular septum pacing (RVSP) as control group. Baseline characteristics were similar between the two groups. With LBBP, the paced QRSd was slightly wider than the intrinsic QRSd (101.03 ± 8.79 ms vs 91.06 ± 14.17 ms, P < .0001) while the LV mechanical synchrony during LBBP pacing mode was similar to that of native-conduction mode (SDI, 3.14 ± 2.49 vs 2.70 ± 1.68, P = 0.129; Tsd-12-LV, 26.43 ± 15.55 vs 25.61 ± 16.07, P = .671) in the LBBP group. The LV synchrony in the LBBP group was superior to the RVSP group significantly. No significant differences in SV (64.08 ± 16.97 mL vs 65.45 ± 18.68 mL, P = .241) or the degree of atrioventricular valvular regurgitation were noted between LBBP capture and native-conduction modes. CONCLUSION LBBP could preserve satisfactory LV synchrony and result in favorable hemodynamic effects.
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Affiliation(s)
- Binni Cai
- Department of Cardiology, Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujianChina
| | - Xinyi Huang
- Department of Echocardiography, Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujianChina
| | - Linlin Li
- Department of Cardiology, Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujianChina
| | - Jincun Guo
- Department of Cardiology, Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujianChina
| | - Simei Chen
- Department of Cardiac Function, Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujianChina
| | - Fanqi Meng
- Department of Cardiology, Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujianChina
| | - Huimin Wang
- Department of Echocardiography, Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujianChina
| | - Biqin Lin
- Department of Echocardiography, Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujianChina
| | - Maolong Su
- Department of Echocardiography, Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujianChina
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Poh CL, Celermajer DS, Grigg LE, Kalman JM, McGuire MA, Gentles TL, Radford DJ, Bullock A, Disney PJS, Winlaw D, du Plessis K, d'Udekem Y. Pacemakers are associated with a higher risk of late death and transplantation in the Fontan population. Int J Cardiol 2019; 282:33-37. [PMID: 30755335 DOI: 10.1016/j.ijcard.2019.01.088] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/08/2019] [Accepted: 01/24/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND The need for permanent pacing has been identified as a predictor of poor outcomes in the late survivors of Fontan surgery. However, it is not clear if the need for a pacemaker is a surrogate marker of a declining Fontan state, or if pacing is deleterious to the Fontan circulation. OBJECTIVES We sought to compare the long-term outcomes of propensity-matched Fontan patients with and without a permanent pacemaker. METHODS Patients who have survived Fontan completion with a documented history of cardiac arrhythmia were identified from the Australia and New Zealand Fontan Registry. Pacemaker insertion details, cardiac function and electrophysiological data were obtained for the patients with a permanent pacemaker. Survival analysis was performed with propensity score matching to compare late survival and outcomes in patients with versus without a pacemaker. RESULTS There was a total of 310 patients with a history of cardiac arrhythmia, of which 126 (41%) had a permanent pacemaker. After propensity-score matching, 99 pairs were generated (n = 198). Patients with a permanent pacemaker had a higher risk of death (HR 3.32 95% CI 1.60-6.90, p = 0.001) and death or transplantation (HR 3.55 95% CI 1.87-6.73, p < 0.001). Patients who were only paced atrially were not at a significantly increased risk of death or transplantation. However, patients who were ventricular paced >50% of the time were much more likely to encounter late death or transplantation (HR 3.82 95% CI 1.64-8.95, p = 0.002). CONCLUSIONS Having a permanent pacemaker and needing ventricular pacing is likely associated with an increased risk of death and transplantation in patients with a Fontan circulation.
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Affiliation(s)
- Chin L Poh
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Murdoch Childrens Research Institute, Heart Research Group, Melbourne, VIC, Australia; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, VIC, Australia
| | - David S Celermajer
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Leeanne E Grigg
- Department of Cardiology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Jonathan M Kalman
- Department of Cardiology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Mark A McGuire
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Thomas L Gentles
- Department of Paediatric Cardiology, Starship Children's Hospital, Auckland, New Zealand
| | - Dorothy J Radford
- Adult Congenital Heart Unit, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Andrew Bullock
- Children's Cardiac Centre, Princess Margaret Hospital for Children, Perth, WA, Australia
| | - Patrick J S Disney
- Department of Cardiovascular Services, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - David Winlaw
- Heart Centre for Children, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Karin du Plessis
- Murdoch Childrens Research Institute, Heart Research Group, Melbourne, VIC, Australia
| | - Yves d'Udekem
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Murdoch Childrens Research Institute, Heart Research Group, Melbourne, VIC, Australia; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, VIC, Australia.
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Babu NMS, Srinath SC, Lahiri A, Chase D, John B, Roshan J. Three-dimensional echocardiography with left ventricular strain analyses helps earlier prediction of right ventricular pacing-induced cardiomyopathy. J Saudi Heart Assoc 2017; 30:102-107. [PMID: 29910580 PMCID: PMC6000885 DOI: 10.1016/j.jsha.2017.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/29/2017] [Accepted: 06/05/2017] [Indexed: 01/10/2023] Open
Abstract
Background and objectives Right ventricular (RV) pacing can lead to progressive ventricular dysfunction over a certain period. This pacemaker-induced cardiomyopathy (PiCMP) may be more common than previously reported. Speckle tracking imaging is a recent development in echocardiography that can identify left ventricular (LV) dysfunction even before the LV ejection fraction (LVEF) value decreases. Three-dimensional (3D) echocardiography has made more accurate assessment of LVEF possible. The objectives of this study are to study the incidence of RV PiCMP using 3D echocardiography and LV strain analysis over a follow-up of 6 months, and to identify its predictors. Methods This is an observational study of consecutive patients without structural heart disease and with a baseline EF of more than 45% who received a permanent pacemaker. They were observed over a 6-month period. PiCMP was defined as a decrease in LVEF by 10 percentage points or a decrease in LV strain by 15% from baseline in the absence of other known causes of cardiomyopathy. PiCMP incidence and its associations were analyzed over a 6-month period. Results The incidence of PiCMP was not only significant over a period of 6 months but also at 24 hours. Significant drops in 3D EF were noted in one (2.8%) patient at 24 hours and in another four (11.1%) patients at 6 months. A significant decrease in LV global longitudinal strain was noted in 23 (63.9%) patients by 6 months. In seven of these patients, there was significant decrease in global longitudinal strain 24 hours after implantation. In analyzing longitudinal strain, the parameter significantly influencing a decrease was a pacing percentage of ≥20% (p = 0.023). Conclusions PiCMP is not uncommon in patients undergoing pacemaker implantation and is associated with RV pacing. PiCMP was associated with a ventricular pacing percentage of ≥20%. 3D echocardiography with LV strain analysis plays a vital role in identifying LV dysfunction at an earlier stage compared to EF. PiCMP, if picked up and intervened upon early, can help impede its progression.
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Affiliation(s)
- N M Sharath Babu
- Department of Cardiology, Christian Medical College, Vellore 632004, IndiaaIndia
| | - Sirish C Srinath
- Department of Cardiology, Christian Medical College, Vellore 632004, IndiaaIndia
| | - Anandaroop Lahiri
- Department of Cardiology, Christian Medical College, Vellore 632004, IndiaaIndia
| | - David Chase
- Department of Cardiology, Christian Medical College, Vellore 632004, IndiaaIndia
| | - Bobby John
- Department of Cardiology, Christian Medical College, Vellore 632004, IndiaaIndia
| | - John Roshan
- Department of Cardiology, Christian Medical College, Vellore 632004, IndiaaIndia
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Yang JH, Kim JY, Kim SH, Oh YS. Reversal of Pacing-Induced Cardiomyopathy by Normal QRS Axis Pacing. Korean Circ J 2016; 46:421-4. [PMID: 27275181 PMCID: PMC4891609 DOI: 10.4070/kcj.2016.46.3.421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 10/08/2015] [Accepted: 10/27/2015] [Indexed: 12/05/2022] Open
Abstract
Right ventricular apical pacing has been a commonly used method for placement of permanent pacemaker, but it is known to be associated with ventricular dyssynchrony and may lead to heart failure. Septal pacing could be an alternative method to improve this complication but the results have been conflicting; hence, other strategies are needed. This case is about a patient with pacing-induced cardiomyopathy who showed much improvement after repositioning the leads to a site different from that of normally paced QRS axis.
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Affiliation(s)
- Ji Hyun Yang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ju Youn Kim
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Hwan Kim
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Seog Oh
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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