Related Experiment Video

Updated: Aug 9, 2026

Implantation of Total Artificial Heart in Congenital Heart Disease
07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

Pacemaker implantation as a risk factor for heart failure in young adults with congenital heart disease

Jörg Nothroff1, Kambiz Norozi, Valentin Alpers

  • 1Department of Pediatric Cardiology and Intensive Care Medicine, University Hospital Göttingen, Georg-August-University, Göttingen, Germany.

Pacing and Clinical Electrophysiology : PACE
|May 3, 2006
PubMed

Insights

Permanent pacemaker implantation in adults with congenital heart disease may increase the risk of heart failure. This study found elevated NT-Pro brain natriuretic peptide and reduced maximal oxygen uptake in patients with pacemakers, suggesting a potential link to heart failure development.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Electrophysiology

Background:

  • Permanent cardiac pacing is indicated for heart block and sinus node dysfunction in children with congenital heart defects.
  • Long-term outcomes of pacing in grown-ups with congenital heart disease (GUCH) require further investigation regarding heart failure risk.

Purpose of the Study:

  • To evaluate if cardiac pacing is a risk factor for heart failure in GUCH patients during long-term follow-up.

Main Methods:

  • Assessed heart failure objectively using NT-Pro brain natriuretic peptide (BNP) and maximal oxygen uptake (VO2max) during cardiopulmonary exercise testing.
  • Studied 346 consecutive GUCH patients during a long-term follow-up examination.

Main Results:

  • Pacemaker patients (n=39) showed significantly elevated BNP (448.2 vs 123.8 pg/mL) and decreased VO2max (22.5 vs 27.4 mL/kg/min) compared to non-pacemaker patients.
  • Pacemaker use was linked to prolonged QRS duration, increased right ventricular end-diastolic diameter, and lower heart rates at rest and exercise.
  • Left ventricular fractional shortening remained normal in both groups.

Conclusions:

  • Pacemaker implantation in GUCH patients may be associated with an increased risk of heart failure, evidenced by elevated BNP and reduced VO2max.
  • Potential contributing factors include QRS prolongation, reduced exercise heart rates, and right ventricular dilatation.
Abstract

More Related Videos

Implantation of the Syncardia Total Artificial Heart16:11

Implantation of the Syncardia Total Artificial Heart

Published on: July 18, 2014

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation08:56

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

Published on: September 24, 2021

Related Concept Videos

Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...