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Mid-term echocardiographic follow up of left ventricular function with permanent right ventricular pacing in

Tchavdar Nikolov Shalganov1, Dora Paprika, Radu Vatasescu

  • 1Department of Pacing and Clinical Electrophysiology, Gottsegen Gyorgy National Institute of Cardiology, Budapest, Hungary. dr.kardos@t-online.hu

Cardiovascular Ultrasound
|March 14, 2007
PubMed

Insights

Chronic right ventricular pacing in children does not generally harm left ventricular function. However, complex congenital heart defects may lead to a decrease in left ventricular shortening fraction over time.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiovascular Research

Background:

  • Chronic right ventricular apical pacing may negatively impact left ventricular function and contribute to heart failure in adults with existing left ventricular dysfunction.
  • Pediatric patients with pacemakers require careful monitoring for potential cardiac effects.

Purpose of the Study:

  • To evaluate the long-term effects of chronic right ventricular pacing on left ventricular function in pediatric patients.
  • To assess whether pacing in pediatric patients with or without structural heart disease influences left ventricular shortening fraction.

Main Methods:

  • Retrospective study of 99 pediatric patients with pacemakers, categorized by underlying heart condition (atrioventricular block or structural heart disease).
  • Follow-up included 12-lead electrocardiogram and transthoracic echocardiography to assess left ventricular shortening fraction and QRS duration.
  • Average follow-up duration was 53 months.

Main Results:

  • Overall, left ventricular shortening fraction did not significantly change post-pacemaker implantation.
  • A significant decrease in left ventricular shortening fraction was observed in patients with complex congenital heart malformations.
  • Six patients developed dilated cardiomyopathy during the follow-up period.

Conclusions:

  • Chronic right ventricular pacing in pediatric patients, with or without structural heart disease, does not consistently lead to a decline in left ventricular function.
  • Pediatric patients with complex congenital heart malformations are at risk for decreased left ventricular function during chronic right ventricular pacing.
Abstract

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