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Early detection of regional myocardial dysfunction in paced children with congenital complete atrioventricular block

Volkan Tuzcu1, Jimmy P Bodtke, Thomas H Best

  • 1Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72202, USA. tuzcuvolkan@uams.edu

Pacing and Clinical Electrophysiology : PACE
|June 6, 2007
PubMed

Insights

Right ventricular pacing causes regional heart muscle dysfunction in children with congenital complete atrioventricular block (CCAVB). Strain echocardiography can detect this early, and dysfunction does not worsen with long-term pacing.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Imaging
  • Electrophysiology

Background:

  • Right ventricular apical pacing is linked to impaired global left ventricular function.
  • Assessing regional myocardial function may enable early detection of pacing-induced cardiac remodeling.
  • Congenital complete atrioventricular block (CCAVB) often requires pacing in children.

Purpose of the Study:

  • To evaluate regional myocardial function in children with CCAVB who undergo right ventricular pacing.
  • To investigate if pacing-induced changes are detectable during intrinsic rhythm.

Main Methods:

  • Strain echocardiography and tissue velocity imaging were used to assess regional myocardial function.
  • 10 children with CCAVB and 14 healthy children were studied.
  • Echocardiograms were acquired during intrinsic junctional rhythm in paced children.

Main Results:

  • Paced children showed significantly increased contraction delays (dSR and dTV) compared to controls.
  • Mean peak strain rates and tissue velocities were reduced in the paced group.
  • Regional dysfunction was most apparent in paced ventricular areas, with no correlation to pacing duration.

Conclusions:

  • Strain echocardiography and tissue velocity imaging can detect regional myocardial dysfunction in paced children with CCAVB during intrinsic rhythm.
  • Long-term right ventricular pacing does not appear to exacerbate pacing-induced regional myocardial remodeling in these children.
Abstract

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