TITLE:
The Prevalence and Short-Term Outcomes of Ventricular Dyssynchrony after Right Ventricular Pacing
AUTHORS:
Thipdhorn Aritajati, Kritsana Tipcome, Anusang Chitsomkasem, Nithi Tokavanich, Teetouch Ananwattanasuk, Padoemwut Teerawongsakul
KEYWORDS:
Right Ventricular Pacing, Ventricular Dyssynchrony, Predictor, Correlation, Heart Failure, Cardiomyopathy, Left Ventricular Ejection Fraction Decline
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.12 No.11,
November
10,
2021
ABSTRACT: Objective: Long-term right ventricular pacing has been associated with an increased risk of heart failure and cardiomyopathy. The pathophysiology of cardiomyopathy associated with right ventricular pacing remains unclear. We aim to evaluate the burden and short-term outcomes of ventricular dyssynchrony after immediate permanent pacemaker implantation. Materials and Methods: This prospective cohort study examined consecutive patients who had permanent pacemaker implantation at Vajira Hospital in 2019. Left ventricular systolic function, specifically left ventricular ejection fraction (LVEF) and echocardiographic ventricular dyssynchrony parameters were assessed. The endpoints included the prevalence of ventricular dyssynchrony, new-onset cardiomyopathy, heart failure, and death. The correlation between QRS complex duration, the burden of ventricular pacing, and echocardiographic ventricular dyssynchrony was measured. Results: Thirty-six consecutive patients underwent pacemaker implantation. The prevalence of mechanical ventricular dyssynchrony was 22.2% using the interventricular conduction delay method, 41.7% using LV pre-ejection period method, and 11.1% using the septal posterior wall motion abnormality method. Electrical ventricular dyssynchrony was 86.1% and new-onset cardiomyopathy was 17.1% after 3 months of permanent pacemaker implantation. The right ventricular pacing of more than 20% was significantly associated with cardiomyopathy (p