Pacing-Induced Cardiomyopathy

Khurshid, Shaan; Frankel, David S.

doi:10.1016/j.ccep.2021.06.009

Cited by 19 publications

(24 citation statements)

References 38 publications

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“…[2][3][4][5] As the number of children and young adults with pacemakers continue to increase, some of these patients will outgrow the length or functionality of the leads, develop right ventricular (RV) pacing-induced cardiomyopathy, or infection necessitating lead revisions, abandonment, or transvenous lead extraction (TLE). 6 Although consensus statements have provided general recommendations for lead management in those with congenital heart disease (CHD), extensive gaps in knowledge remain regarding long-term risks associated with lead management and TLE in those with CCHB. 7 It may be thought that the prolonged lead dwelling time and multiple leads can lead to a high burden of intravascular lead adherence, calcification, and vascular occlusions that contribute to a perceived high risk of complications in this population; however, no data currently exist to aid in the shared-decision making process.…”

Section: Introductionmentioning

confidence: 99%

Transvenous laser lead extraction in patients with congenital complete heart block

et al. 2022

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Section: Introductionmentioning

confidence: 99%

Transvenous laser lead extraction in patients with congenital complete heart block

et al. 2022

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“…Proper pacemaker programming—in accordance with the individual needs resulting from the type of arrhythmia, the indications for pacemaker implantation, and the patient’s lifestyle and preferences—has a crucial impact on improving heart function. It is also important to avoid replacing the intrinsic rhythm with pacing unnecessarily, due to the risk of pacing-induced cardiomyopathy [ 134 ].…”

Section: Discussionmentioning

confidence: 99%

Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications

Świerżyńska

Oręziak

Główczyńska

et al. 2023

Sensors

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Modern cardiac pacemakers are equipped with a function that allows the heart rate to adapt to the current needs of the patient in situations of increased demand related to exercise and stress ("rate-response" function). This function may be based on a variety of mechanisms, such as a built-in accelerometer responding to increased chest movement or algorithms sensing metabolic demand for oxygen, analysis of intrathoracic impedance, and analysis of the heart rhythm (Q-T interval). The latest technologies in the field of rate-response functionality relate to the use of an accelerometer in leadless endocavitary pacemakers; in these devices, the accelerometer enables mapping of the mechanical wave of the heart's work cycle, enabling the pacemaker to correctly sense native impulses and stimulate the ventricles in synchrony with the cycles of atria and heart valves. Another modern system for synchronizing pacing rate with the patient's real-time needs requires a closed-loop system that continuously monitors changes in the dynamics of heart contractions. This article discusses the technical details of various solutions for detecting and responding to situations related to increased oxygen demand (e.g., exercise or stress) in implantable pacemakers, and reviews the results of clinical trials regarding the use of these algorithms.

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“…RV PiCM is usually defined as LV systolic dysfunction resulting from electrical and mechanical dyssynchrony caused by RV pacing. RV PiCM is common and occurs in 10-20% of patients exposed to frequent RV pacing [ 46 ] . Multiple risk factors for PiCM have been identified, and the most investigated predictors are of clinical (HF), electrocardiographic (morphology and QRS duration), and echocardiographic (LVEF) natures [ 1 , 46 - 48 ] .…”

Section: Predictors Of Picmmentioning

confidence: 99%

“…RV PiCM is common and occurs in 10-20% of patients exposed to frequent RV pacing [ 46 ] . Multiple risk factors for PiCM have been identified, and the most investigated predictors are of clinical (HF), electrocardiographic (morphology and QRS duration), and echocardiographic (LVEF) natures [ 1 , 46 - 48 ] . However, a review of the available studies revealed a significant heterogeneity of results, given that PiCM has only recently been more deeply studied and acknowledged, and individualizing patients at higher risk is especially challenging in this context.…”

Section: Predictors Of Picmmentioning

confidence: 99%

Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development

Ferrari

Oliveira

Tagliari

et al. 2023

Braz J Cardiovasc Surg

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Coordinated and harmonic (synchronous) ventricular electrical activation is essential for better left ventricular systolic function. Intraventricular conduction abnormalities, such as left bundle branch block due to artificial cardiac pacing, lead to electromechanical “dyssynchronopathy” with deleterious structural and clinical consequences. The aim of this review was to describe and improve the understanding of all the processes connecting the several mechanisms involved in the development of artificially induced ventricular dyssynchrony by cardiac pacing, most known as pacing-induced cardiomyopathy (PiCM). The chronic effect of abnormal impulse conduction and nonphysiological ectopic activation by artificial cardiac pacing is suspected to affect metabolism and myocardial perfusion, triggering regional differences in the activation/contraction processes that cause electrical and structural remodeling due to damage, inflammation, and fibrosis of the cardiac tissue. The effect of artificial cardiac pacing on ventricular function and structure can be multifactorial, and biological factors underlying PiCM could affect the time and probability of developing the condition. PiCM has not been included in the traditional classification of cardiomyopathies, which can hinder detection. This article reviews the available evidence for pacing-induced cardiovascular disease, the current understanding of its pathophysiology, and reinforces the adverse effects of right ventricular pacing, especially right ventricular pacing burden (commonly measured in percentage) and its repercussion on ventricular contraction (reflected by the impact on left ventricular systolic function). These effects might be the main defining criteria and determining mechanisms of the pathophysiology and the clinical repercussion seen on patients.

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Pacing-Induced Cardiomyopathy

Cited by 19 publications

References 38 publications

Transvenous laser lead extraction in patients with congenital complete heart block

Transvenous laser lead extraction in patients with congenital complete heart block

Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications

Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development

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