Assessment of heart failure and left ventricular systolic dysfunction after cardiac pacing in patients with preserved left ventricular systolic function

Kachboura, Salem; Halima, Afef Ben; Fersi, I.; Marrakchi, S.; Zouaoui, W.; Kammoun, Ikram

doi:10.1016/j.ancard.2007.09.011

Cited by 7 publications

(3 citation statements)

References 40 publications

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“…As described previously, increased rates of RV pacing are associated with a reduction in left ventricular ejection fraction and symptomatic heart failure. It is plausible that pacing-induced cardiomyopathy acts as a substrate for increased ventricular arrhythmias and/or vice versa (Chan et al, 2011;Curtis et al, 2013;Kachboura et al, 2008;Wilkoff et al, 2002). Contrary to physiological ventricular activation, RV pacing can result in ventricular dyssynchrony (Cronin et al, 2017;Wilkoff et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Right ventricular pacing is associated with increased rates of appropriate implantable cardioverter defibrillator shocks

Arcinas

McIntyre

Farag

et al. 2019

Noninvasive Electrocardiol

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Section: Discussionmentioning

confidence: 99%

Right ventricular pacing is associated with increased rates of appropriate implantable cardioverter defibrillator shocks

Arcinas

McIntyre

Farag

et al. 2019

Noninvasive Electrocardiol

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“…Therefore, RV pacing in patients with VR-ICDs should alert medical doctors whether RV pacing is necessary (a newly developed brady-pacing requirement) or not. Vp leading to ventricular dyssynchrony is hazardous even in patients with preserved LV systolic functions and might result in an enhanced risk of heart failure hospitalizations and AF (7, 11). Additionally, Steinberg et al (12) demonstrated that RV pacing not only enhanced heart failure episodes but also increased VT/VF, requiring ICD therapy in patients with ICDs.…”

Section: Discussionmentioning

confidence: 99%

Should physicians instead of industry representatives be the main actor of cardiac implantable electronic device follow-up? (Super Follow-up)

Üreyen

Baş²,

Yüksel³

et al. 2017

Anatol J Cardiol

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Objective:This retrospective study sought to research the adequacy of the follow-up and optimization of cardiac implantable electronic devices (CIEDs) performed by industry representatives.Methods:A total of 403 consecutive patients (35% females; median age, 67 years; age range 18–97 years) with either pacemakers (n=246), implantable cardioverter-defibrillators (ICDs), (n=117) or cardiac resynchronization therapy with defibrillator (CRT-D) (n=40) applied to our hospital’s outpatient pacemaker clinic for follow-up. These patients had been followed up by industry representatives alone until September 2013 and then by a cardiologist who is dealing with cardiac electrophysiology and has a knowledge of CIED follow-up.Results:It was ascertained that 117 (47.6%) of 246 patients with pacemakers had a programming error. Forty-three (36.8%) of 117 patients were symptomatic, and after reprogramming, all symptoms diminished partially or completely during the follow-up. Moreover, 30 (25.6%) of 117 patients with ICDs had a programming error. Furthermore, 6 (15%) of 40 patients with CRT-Ds had a programming error. To conclude, when all patients with CIEDs were assessed together, it was ascertained that 153 (38%) of 403 patients had programming errors.Conclusion:The prevalence of inappropriate programming of CIEDs by industry representatives was quite higher than expected. Therefore, our study strongly demonstrates that CIED follow-up should not be allowed to be performed entirely by manufacturers’ representatives alone.

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“…RV apical pacing is associated with asynchronous electrical activation of the left ventricle which impairs cardiac systolic and diastolic function and induces regional perfusion defects even in the absence of coronary artery disease [ 22 - 25 ].…”

Section: Discussionmentioning

confidence: 99%

Reverse left ventricular remodeling is more likely in non ischemic cardiomyopathy patients upgraded to biventricular stimulation after chronic right ventricular pacing

Morales

Startari

Rossi

et al. 2011

Cardiovasc Ultrasound

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BackgroundChronic right ventricular (RV) apical pacing may lead to left ventricular (LV) dyssynchrony and LV dysfunction. In heart failure due to RV pacing, upgrading to biventricular stimulation (CRT) can improve NYHA Class and LV function. A proportion of patients do not respond to upgrading. Aim was to assess whether etiology of LV dysfunction accounts for responses to CRT in RV-paced patients.MethodsSixty-two patients treated by CRT, under RV pacing from 50.2 ± 5.4 months, were studied. Cause of LV dysfunction was non-ischemic (NIC) in 28 and ischemic cardiomyopathy (IC) in 34 patients. Clinical and conventional echocardiographic parameters were available within 1 month before RV pacing, within 1 month before CRT and at 12 ± 2 months of follow-up (FU).ResultsDecreased LVEF (from 37.0 ± 8.8 to 25.6 ± 6.1%, p <0.001), increased LV end-systolic dimensions (LVESD) (from 48.1 ± 8.6 to 55.2 ± 7.9 mm, p <0.001) and worsened NYHA Class (from 1.9 ± 1.1 to 3.2 ± .6, p < 0.005) were found before CRT, compared to pre RV-pacing. After CRT, 44/62 patients showed a ≥ 1 NYHA Class improvement; >10% decrease in LVESD was observed in 24 patients: 5 with IC, 19 with NIC (p < .0.001). The association between cause of LV dysfunction with >10% decrease in LVESD remained highly significant (p < 0.001) adjusting for pre-CRT QRS duration, NYHA Class, LVEF, LVESD, treatment or RV pacing duration.ConclusionsCRT improves functional class even after long-lasting pacing. Reverse remodeling is evident in a small population, more likely with NIC.

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Assessment of heart failure and left ventricular systolic dysfunction after cardiac pacing in patients with preserved left ventricular systolic function

Cited by 7 publications

References 40 publications

Right ventricular pacing is associated with increased rates of appropriate implantable cardioverter defibrillator shocks

Right ventricular pacing is associated with increased rates of appropriate implantable cardioverter defibrillator shocks

Should physicians instead of industry representatives be the main actor of cardiac implantable electronic device follow-up? (Super Follow-up)

Reverse left ventricular remodeling is more likely in non ischemic cardiomyopathy patients upgraded to biventricular stimulation after chronic right ventricular pacing

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