Cargando…

Effect of right ventricular pacing on left ventricular systolic function in patients with Tetralogy of Fallot

BACKGROUND: Prevalence of pacemaker-induced cardiomyopathy (PICM) in adults with congenital heart disease is unknown. Tetralogy of Fallot (TOF) is a common diagnosis in the adult congenital heart disease population, and the purpose of this study was to determine association between frequent right ve...

Descripción completa

Detalles Bibliográficos
Autores principales: Egbe, Alexander C., Najam, Maria, Banala, Keerthana, Vojjini, Rahul, Osman, Karim, Abhishek, Deshmukh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864126/
https://www.ncbi.nlm.nih.gov/pubmed/31763440
http://dx.doi.org/10.1016/j.ijcha.2019.100426
_version_ 1783471829932834816
author Egbe, Alexander C.
Najam, Maria
Banala, Keerthana
Vojjini, Rahul
Osman, Karim
Abhishek, Deshmukh
author_facet Egbe, Alexander C.
Najam, Maria
Banala, Keerthana
Vojjini, Rahul
Osman, Karim
Abhishek, Deshmukh
author_sort Egbe, Alexander C.
collection PubMed
description BACKGROUND: Prevalence of pacemaker-induced cardiomyopathy (PICM) in adults with congenital heart disease is unknown. Tetralogy of Fallot (TOF) is a common diagnosis in the adult congenital heart disease population, and the purpose of this study was to determine association between frequent right ventricular (RV) pacing and temporal decrease in left ventricular ejection fraction (LVEF) from pre-implantation to 2-years post-implantation (LVEF(post-pre)) in TOF patients. METHODS: We studied TOF patients that received RV leads only (N = 51) and a reference group of 7 patients with atrial pacing or biventricular pacing. We defined PICM as a ≥10% decrease in LVEF resulting in LVEF <50%. Linear regression was used to assess relationship between frequent RV pacing (≤20%, 21–40%, >40%) and LVEF(post-pre). RESULTS: PICM occurred in 2 (4%) of 51 patients in RV pacing group. LVEF(post-pre) was +3% (95% confidence interval [CI] 0% to +5%) in the reference group and −4% (95% CI −11% to +2%) in RV pacing group. No significant difference occured in LVEF(post-pre) between the reference group (LVEF(post-pre) +3%) vs RV pacing ≤20% (LVEF(post-pre) +1%) vs RV pacing 21–40% (LVEF(post-pre) −3%) vs RV pacing >40% (LVEF(post-pre) −5%), p = 0.318. There was also no association between frequent RV pacing and LVEF(post-pre), R(2) = 0.307, p = 0.10. CONCLUSION: PICM occurred in 4% of TOF patients receiving RV pacing, and there was no association between frequent RV pacing and temporal decline in LVEF. Further studies are required to determine the long-term impact of RV pacing in the TOF population, and explore optimal treatment strategies.
format Online
Article
Text
id pubmed-6864126
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-68641262019-11-22 Effect of right ventricular pacing on left ventricular systolic function in patients with Tetralogy of Fallot Egbe, Alexander C. Najam, Maria Banala, Keerthana Vojjini, Rahul Osman, Karim Abhishek, Deshmukh Int J Cardiol Heart Vasc Original Paper BACKGROUND: Prevalence of pacemaker-induced cardiomyopathy (PICM) in adults with congenital heart disease is unknown. Tetralogy of Fallot (TOF) is a common diagnosis in the adult congenital heart disease population, and the purpose of this study was to determine association between frequent right ventricular (RV) pacing and temporal decrease in left ventricular ejection fraction (LVEF) from pre-implantation to 2-years post-implantation (LVEF(post-pre)) in TOF patients. METHODS: We studied TOF patients that received RV leads only (N = 51) and a reference group of 7 patients with atrial pacing or biventricular pacing. We defined PICM as a ≥10% decrease in LVEF resulting in LVEF <50%. Linear regression was used to assess relationship between frequent RV pacing (≤20%, 21–40%, >40%) and LVEF(post-pre). RESULTS: PICM occurred in 2 (4%) of 51 patients in RV pacing group. LVEF(post-pre) was +3% (95% confidence interval [CI] 0% to +5%) in the reference group and −4% (95% CI −11% to +2%) in RV pacing group. No significant difference occured in LVEF(post-pre) between the reference group (LVEF(post-pre) +3%) vs RV pacing ≤20% (LVEF(post-pre) +1%) vs RV pacing 21–40% (LVEF(post-pre) −3%) vs RV pacing >40% (LVEF(post-pre) −5%), p = 0.318. There was also no association between frequent RV pacing and LVEF(post-pre), R(2) = 0.307, p = 0.10. CONCLUSION: PICM occurred in 4% of TOF patients receiving RV pacing, and there was no association between frequent RV pacing and temporal decline in LVEF. Further studies are required to determine the long-term impact of RV pacing in the TOF population, and explore optimal treatment strategies. Elsevier 2019-11-14 /pmc/articles/PMC6864126/ /pubmed/31763440 http://dx.doi.org/10.1016/j.ijcha.2019.100426 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Paper
Egbe, Alexander C.
Najam, Maria
Banala, Keerthana
Vojjini, Rahul
Osman, Karim
Abhishek, Deshmukh
Effect of right ventricular pacing on left ventricular systolic function in patients with Tetralogy of Fallot
title Effect of right ventricular pacing on left ventricular systolic function in patients with Tetralogy of Fallot
title_full Effect of right ventricular pacing on left ventricular systolic function in patients with Tetralogy of Fallot
title_fullStr Effect of right ventricular pacing on left ventricular systolic function in patients with Tetralogy of Fallot
title_full_unstemmed Effect of right ventricular pacing on left ventricular systolic function in patients with Tetralogy of Fallot
title_short Effect of right ventricular pacing on left ventricular systolic function in patients with Tetralogy of Fallot
title_sort effect of right ventricular pacing on left ventricular systolic function in patients with tetralogy of fallot
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864126/
https://www.ncbi.nlm.nih.gov/pubmed/31763440
http://dx.doi.org/10.1016/j.ijcha.2019.100426
work_keys_str_mv AT egbealexanderc effectofrightventricularpacingonleftventricularsystolicfunctioninpatientswithtetralogyoffallot
AT najammaria effectofrightventricularpacingonleftventricularsystolicfunctioninpatientswithtetralogyoffallot
AT banalakeerthana effectofrightventricularpacingonleftventricularsystolicfunctioninpatientswithtetralogyoffallot
AT vojjinirahul effectofrightventricularpacingonleftventricularsystolicfunctioninpatientswithtetralogyoffallot
AT osmankarim effectofrightventricularpacingonleftventricularsystolicfunctioninpatientswithtetralogyoffallot
AT abhishekdeshmukh effectofrightventricularpacingonleftventricularsystolicfunctioninpatientswithtetralogyoffallot