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Electrocardiographic alterations after chronic right ventricular apical pacing in patients with sinus node
Li-Gang Ding1, Wei Hua, Jian-Min Chu
1Center of Arrhythmia Diagnosis and Treatment, Fuwai Hospital and Cardiovascular Institute, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China.
Journal of Electrocardiology
|January 23, 2009
Summary
Chronic right ventricular apical pacing in patients with sinus node dysfunction can prolong intrinsic QRS duration. Elderly age, pacing, and coronary artery disease independently predict this electrical remodeling.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Sinus node dysfunction (SND) necessitates pacemaker implantation.
- Right ventricular apical (RVA) pacing is a common approach for SND.
- Potential for RVA pacing to induce electrical remodeling is a clinical concern.
Purpose of the Study:
- To investigate electrical remodeling induced by chronic RVA pacing in patients with SND.
- To identify predictors of QRS duration prolongation in this patient cohort.
Main Methods:
- Study included 92 patients with SND undergoing initial pacemaker implantation.
- Electrocardiograms and echocardiograms were recorded during follow-up.
- A control group of 45 patients was also analyzed.
Main Results:
- Mean follow-up was 3.3 years.
- Intrinsic QRS duration increased significantly (P < .001).
- Left ventricular end-diastolic diameter increased, and ejection fraction decreased (P < .001).
- Elderly age, RVA pacing, and coronary artery disease were independent predictors of QRS prolongation.
Conclusions:
- Chronic RVA pacing may lead to prolonged intrinsic QRS duration.
- Elderly age, RVA pacing, and coronary artery disease independently predict this QRS prolongation.
- Findings highlight potential long-term electrical consequences of RVA pacing.
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