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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Chronic left ventricular pacing preserves left ventricular function in children.

Irene E van Geldorp¹, Ward Y Vanagt, Urs Bauersfeld

¹Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, and Department of Pediatrics, University Hospital Maastricht, P.O. Box 616, NL-6200 MD, Maastricht, The Netherlands. i.vangeldorp@fys.unimaas.nl

Pediatric Cardiology

|August 16, 2008

Summary

This summary is machine-generated.

Chronic right ventricular pacing in children impairs left ventricular function, unlike left ventricular pacing. Left ventricular pacing preserves cardiac function, indicating it may be a better option for pediatric patients requiring long-term pacing.

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Area of Science:

Pediatric Cardiology
Cardiac Electrophysiology
Echocardiography

Background:

Chronic right ventricular (RV) pacing can lead to adverse structural and functional changes in the heart.
Animal studies suggest left ventricular (LV) pacing may be more beneficial than RV pacing.

Purpose of the Study:

To compare the effects of chronic RV pacing versus LV pacing on cardiac function in children.
To evaluate LV structure, function, and dyssynchrony in pediatric patients undergoing chronic pacing.

Main Methods:

Retrospective analysis of echocardiographic data from 18 healthy children (controls), 7 children with RV pacing (RVP), and 7 children with LV pacing (LVP).
Assessed LV end-diastolic and end-systolic dimensions and wall thickness, shortening fraction, LV eccentricity index, QRS duration, and septal-posterior wall motion delay (SPWMD).

Main Results:

No significant differences in LV dimensions or wall thickness between RVP, LVP, and control groups.
Shortening fraction was significantly lower in the RVP group compared to LVP and control groups.
LV eccentricity index and SPWMD were significantly higher in the RVP group, indicating impaired LV function and mechanical dyssynchrony.

Conclusions:

Chronic RV pacing in children is associated with reduced left ventricular function and increased mechanical dyssynchrony.
Chronic LV pacing appears to preserve left ventricular function in pediatric patients.
LV pacing may be a preferable strategy for long-term pacing in children to mitigate adverse cardiac remodeling.