Dilated Cardiomyopathy Following Right Ventricular Pacing for AV Block in Young Patients: Resolution After Upgrading to Biventricular Pacing Systems

Moak, Jeffrey P.; Hasbani, Keren; Ramwell, Carolyn; Freedenberg, Vicki; Berger, John; DiRusso, Gregory B.; Callahan, Patrick M.

doi:10.1111/j.1540-8167.2006.00565.x

Cited by 117 publications

(97 citation statements)

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“…Experience with chronic biventricular pacing in children is sparse, but a multicenter study showed promising results with regard to cardiac function after 4 months of resynchronization therapy [11], and biventricular pacing proved effective in the treatment of six children with RV pacing-induced heart failure [20]. In adults with congestive heart failure, chronic LV lateral wall pacing (single-site, short AV delay) can be as effective as biventricular pacing [4,12,33].…”

Section: Relation Between Pacing Site and LV Functionmentioning

confidence: 99%

“…During chronic RV pacing in children, LV function, morphology [30,31], and histology [15] are at risk for deterioration over time (for review see Karpawich [16]). Chronic RV pacing can eventually result in cardiac failure, which occurs in 6% to 7% of children [17,20,38]. Also, in adults, chronic RV apex pacing has deleterious effects (for review see Manolis [19]) and increases the risk of heart failure [1,28].…”

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Chronic Left Ventricular Pacing Preserves Left Ventricular Function in Children

et al. 2008

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Chronic right ventricular (RV) pacing can induce structural and functional cardiac deterioration. Because animal studies showed a benefit of left ventricular (LV) over RV pacing, this study compared the effects of chronic RV and LV pacing in children. Retrospectively, echocardiographic data were evaluated from 18 healthy children (control subjects) and from children undergoing chronic epicardial RV pacing (7 RVP) or LV pacing (7 LVP). Assessment included LV end-diastolic wall thickness (LVEDWT) and end-systolic wall thickness (LVESWT) as well as LV end-diastolic diameter (LVEDD) and end-systolic diameter (LVESD). The shortening fraction and eccentricity index (LV diameter/2 9 LV wall thickness) were calculated as measures of LV function and eccentricity, respectively. Duration of QRS and septal posterior wall motion delay (SPWMD) were used as measures of electrical and mechanical dyssynchrony, respectively. A p value less than 0.05 determined significance. As the findings showed, LVEDD, LVESD, LVEDWT, and LVESWT were not significantly different between the groups. The shortening fraction was significantly lower in the RVP (21.7% ± 6.0%) than in the LVP (32.2% ± 5.2%) or control (29.3% ± 4.3%) children. The systolic LV eccentricity index was significantly larger in the RVP (1.8 ± 0.2) than in the LVP (1.4 ± 0.1) or control (1.4 ± 0.2) children. The SPWMD was significantly larger in the RVP (338 ± 20 ms) than in the LVP (-16 ± 14 ms) or control (-5 ± 35 ms) group, whereas QRS duration was similarly longer in the RVP (157 ± 10 ms) and LVP (158 ± 22 ms) groups compared than in the control group (69 ± 7 ms). The authors conclude that LV function in children is preserved by chronic pacing at the LV lateral wall.Keywords Cardiac function Á Children Á Dyssynchrony Á Pacing Á Site Á Ventricular In children and adults with congenital or acquired atrioventricular (AV) block, the ventricular pacing lead is traditionally positioned at the right ventricle (RV) [16,19]. However, RV apex pacing causes an acute decrease in left ventricular (LV) function in animals [26], adults [6] and children [14,36]. During chronic RV pacing in children, LV function, morphology [30,31], and histology [15] are at risk for deterioration over time (for review see Karpawich [16]). Chronic RV pacing can eventually result in cardiac failure, which occurs in 6% to 7% of children [17,20,38]. Also, in adults, chronic RV apex pacing has deleterious effects (for review see Manolis [19]) and increases the risk of heart failure [1,28].Recognition of the possible harmful effects from RV apex pacing initiated the search for alternative ventricular pacing sites including the RV outflow tract, His bundle, LV wall, and biventricular pacing. Pacing at the His bundle is likely the superior approach [8], but appears to be

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Section: Relation Between Pacing Site and LV Functionmentioning

confidence: 99%

mentioning

confidence: 99%

Chronic Left Ventricular Pacing Preserves Left Ventricular Function in Children

et al. 2008

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“…The important question which has arisen following recent reports of pacing-induced cardiomyopathy is: should permanent pacing from the RV apex (for transvenous systems) Moak et al, 2006;Beaufort-Krol et al, 2007;Kim et al, 2007;Vatasescu et al, 2007;Gebauer et al, 2009). Most studies found an incidence of dilated cardiomyopathy and LV dilation in 6.0 to 13.4% of children after long-term pacing.…”

Section: Should Right Ventricular Apical Pacing Be Avoided In Childrementioning

confidence: 99%

Pacing Therapy in Infants and Children with Congenital and Acquired Complete Atrioventricular Block: Optimal Pacing Strategies, Management, and Follow-up

Cate¹,

Sreeram²

2011

Modern Pacemakers - Present and Future

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“…Características Demográficas e Clínicas Basais Gênero feminino, n (%) 43 Em todos os casos foi observado coração em situs solitus, em levocardia e ausência de defeitos em septo ou valvas cardíacas(Anexo G).…”

Section: Tabela 1 -Características Demográficas E Clínicas Dos Sujeitunclassified

“…A reversão do processo de remodelamento ventricular pela terapia de ressincronização cardíaca, que é obtida pela mudança do tipo de marca-passo de VD para biventricular, tem sido relatada em vários estudos [40][41][42][43][44][45][46][47][48][49] . …”

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Avaliação da estimulação ventricular direita crônica em crianças e adultos jovens com bloqueio atrioventricular congênito isolado

Junior¹,

de²

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Avaliação da estimulação ventricular direita crônica em crianças e adultos jovens com bloqueio atrioventricular congênito isoladoincentivo profissional e intelectual dentro e fora do marca-passo. À Dra. Elizabeth Sartori Crevelari, pelo apoio e amizade dentro e fora do centro cirúrgico.Aos amigos e irmãos, os Doutores Luiz Tenório, Orly Larceda, JoséRenato e Aldryn Nunes, por terem me incentivado a entrar na Pós-graduação e, sobretudo, pela amizade espontânea que nos anima até hoje cada qual a seu modo e apesar das distâncias.Ao Amigo Dr. Caio Marcos de Moraes Albertini, pelo companheirismo e incentivo pessoal e profissional. À Dra. Sávia Cristina Bueno, ex-companheira de Pós-Graduação, pelo convívio e ajuda na execução dos créditos. Sem você teria sido mais difícil. À Enfermeira Marianna Sobral Lacerda, pela amizade, apoio e diligência na coleta dos dados deste trabalho.Aos Pesquisadores Tatiana Kawauchi e Lucas Bassolli, pela contribuição na finalização desta tese, seja na elaboração do artigo, seja na análise estatística, respectivamente.

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Dilated Cardiomyopathy Following Right Ventricular Pacing for AV Block in Young Patients: Resolution After Upgrading to Biventricular Pacing Systems

Abstract: CRT can benefit young patients that develop CHF and DCM following RV pacing for AV block. Upgrading to biventricular pacing systems should be considered early in the management of these patients prior to listing for cardiac transplantation.

Cited by 117 publications

References 19 publications

Chronic Left Ventricular Pacing Preserves Left Ventricular Function in Children

Chronic Left Ventricular Pacing Preserves Left Ventricular Function in Children

Pacing Therapy in Infants and Children with Congenital and Acquired Complete Atrioventricular Block: Optimal Pacing Strategies, Management, and Follow-up

Avaliação da estimulação ventricular direita crônica em crianças e adultos jovens com bloqueio atrioventricular congênito isolado

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