Pacing-induced cardiomyopathy in patients with right ventricular stimulation for >15 years

Abstract

Considering the very long duration of RV stimulation in our study population (24.6 ± 6.6 years), the prevalence of PiCMP was remarkably low. Pacing-induced cardiomyopathy was associated with more pronounced intraventricular dyssynchrony.

Left Ventricular Reverse Remodeling With Biventricular Versus Right Ventricular Pacing in Patients With Atrioventricular Block and Heart Failure in the BLOCK HF Trial

“…However, chronic RV pacing has been shown to be associated with new-onset HF, a condition that has been called RV pacinginduced cardiomyopathy. [9][10][11] This condition occurs in ≈20% of patients after prolonged periods of RV pacing. 11 In this analysis, we assessed the effect of biventricular versus RV pacing in HF patients with AVB with 2 specific aims (1) to determine whether biventricular pacing has a consistently greater and more favorable effect than RV pacing on LV reverse remodeling and attenuation of progressive LV dysfunction; and (2) to detect differences in LV architecture, function, and intraventricular mechanical delay (IVMD) associated with biventricular versus RV pacing using transthoracic echocardiography.…”

“…An alternative explanation for our findings is that RV pacing-induced cardiomyopathy must be mild, rare, or occur only after considerably longer RV stimulation. 11 We examined the potential modifying effects of several possible confounders that included age, sex, NYHA class, and LVESVI. Previous studies have reported a greater response to biventricular pacing in women than men, 6,14 which we were unable to confirm.…”

Cardiac Resynchronization Therapy Is Appropriate for All Patients Requiring Chronic Right Ventricular Pacing

“…[22][23][24][25][26][27] For patients with a normal baseline LVEF, a follow-up LVEF of 45% or greater in the absence of other causes for LV dysfunction is generally considered to represent PICM. Table 1 suggests that the incidence of PICM is 15% to 30% after a follow-up of 3 to 8 years and correlates with the duration of pacing (Fig.…”

“…11,[22][23][24][25][26][27] In addition, patients with a normal LVEF are less likely to develop PICM. 1-3 Male gender, older age, coronary artery disease, and a wide native QRS complex are risk factors for pacing-induced cardiomyopathy.…”

“…1-3 Male gender, older age, coronary artery disease, and a wide native QRS complex are risk factors for pacing-induced cardiomyopathy. [22][23][24][25][26][27] Khurshid and colleagues 22 found that a QRS duration of greater than 115 ms (excluding typical bundle branch block) was 90% specific for developing PICM. Table 2 shows that percentage of pacing was greater than 90% in most observational studies.…”