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Left ventricular synchrony and function in pediatric patients with definitive pacemakers
Arquivos Brasileiros De Cardiologia
|September 25, 2013
Summary
Right ventricular pacing (RVP) impairs left ventricular (LV) function and synchrony in children. Left ventricular pacing (LVP) preserves LV function and synchrony, making it a better choice for pediatric patients.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
- Cardiac Pacing
Background:
- Chronic right ventricular pacing (RVP) can lead to dyssynchronous contractions, causing interventricular and intraventricular asynchrony.
- RVP is associated with impaired left ventricular (LV) form and function in numerous studies.
Purpose of the Study:
- To compare LV synchrony and function in pediatric patients undergoing RVP versus LV pacing (LVP).
Main Methods:
- Eighty pediatric patients with complete atrioventricular block were divided into two groups: RVP (n=40) and LVP (n=40).
- Echocardiographic assessment of LV systolic and diastolic function and synchrony was performed before implantation, immediately after, and at a mean 6.8-year follow-up.
Main Results:
- LV diastolic function remained unchanged in all patients.
- LV systolic function was preserved in the LVP group.
- The RVP group showed significant decreases in shortening fraction and ejection fraction, along with increased interventricular and LV mechanical delays compared to the LVP group.
Conclusions:
- Left ventricular epicardial pacing is superior to right ventricular endocardial pacing for preserving cardiac synchrony and function in pediatric patients.
- LV pacing is an optimal site for pacing in pediatric patients to maintain cardiac health.
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