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The prevalence of heart failure and asymptomatic left ventricular systolic dysfunction in a typical regional

Simon D R Thackray1, Klaus K A Witte, Nikolay P Nikitin

  • 1Castle Hill Hospital, University of Hull, Cottingham, Hull, UK. simonthackery@hotmail.com

European Heart Journal
|June 14, 2003
PubMed

Insights

Heart failure is common in patients with pacemakers, affecting 31% of those studied. Many cases of heart failure and left ventricular systolic dysfunction go undiagnosed in this high-risk population.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Research

Background:

  • Chronic pacing is a common intervention for various cardiac conditions.
  • Left ventricular systolic dysfunction (LVSD) can be a consequence of long-term pacing.
  • Early detection of heart failure (HF) in paced patients is crucial for management.

Purpose of the Study:

  • To determine the prevalence of heart failure and asymptomatic LVSD in patients with long-term pacemakers.
  • To identify risk factors associated with HF in this population.

Main Methods:

  • Retrospective analysis of 307 patients attending pacemaker follow-up.
  • Inclusion of medical history, physical examination, 6-minute walk test, and echocardiography.
  • Assessment of left ventricular ejection fraction (LVEF) and heart failure symptoms (NYHA classification).

Main Results:

  • 31% of patients had LVEF <40%, indicating LVSD.
  • 83% of those with LVSD presented with symptomatic heart failure (NYHA II-IV).
  • Higher HF prevalence observed in single-chamber vs. dual-chamber pacing and in chronic atrial fibrillation vs. sinus rhythm.

Conclusions:

  • Heart failure due to LVSD is a significant issue in the chronically paced population.
  • A substantial number of HF cases in paced patients are undiagnosed or undertreated.
  • Echocardiographic screening is recommended for early diagnosis and improved management of HF in this high-risk group.
Abstract

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