Left Ventricular Volumes and Systolic Function After Long-term Right Ventricular Pacing May be Predicted by Paced QRS Duration, but not Pacing Site - 09/01/14
, Ho-Chuen Yuen, MBBS, Chi-Chung Choy, MBBS, Ngai-Shing Mok, MBBS, Ping-Tim Tsui, MBBS, Chun-Leung Lau, MBBS, Ying-Keung Lo, MBBS, Pui-Shan Chu, MBBS, Hoi-Fan Chow, MBBSRésumé |
Background |
Long-term right ventricular apical (RVA) pacing causes adverse left ventricular (LV) remodelling and clinical outcomes.
Methods |
Forty-one patients (19 men, mean age 70.9±14.2, 23 right ventricular septal and 18 RVA pacing) underwent pacemaker implantation for atrioventricular block. LV volumes and left ventricular ejection fraction (LVEF) were assessed by echocardiography 39.3±17.2 months after implantation. Predictors of left ventricular systolic volume (LVESV), left ventricular diastolic volume (LVEDV) and LVEF were analysed.
Results |
No difference was found between RVA pacing and right ventricular septal pacing groups in LVESV (40.6±22.6 vs 33±14.4ml; p=0.199), LVEDV (88.2±31.2 vs 73.7±23.9ml; p=0.102) and LVEF (56.1±8.6 vs 56±6.6%; p=0.996). With multivariate stepwise regression, only pQRSd and renal impairment independently predicted LVESV (β=0.522, 95% CI: 0.242–0.802; p=0.001 and β=40.3, 95% CI: 17.6–62.9; p=0.001 respectively), LVEDV (β=0.786, 95% CI: 0.338–1.235; p=0.001 and β=42.8, 95% CI: 6.6–79; p=0.022 respectively) and LVEF (β=−0.161, 95% CI: −0.283 to −0.04; p=0.011 and β=−14.8, 95% CI: −24.6 to −5.0; p=0.004 respectively).
Conclusions |
pQRSd and renal impairment, but not pacing site or baseline LVEF, may be predictors for LV volumes and systolic function after long-term RV pacing. pQRSd may be target for pacing site optimisation.
Le texte complet de cet article est disponible en PDF.Keywords : Electrocardiography, Cardiac pacing, Right ventricular septal pacing, Right ventricular apical pacing, Left ventricular volumes, Left ventricular remodelling
Plan
Vol 23 - N° 1
P. 43-48 - janvier 2014 Retour au numéro
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