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Pacing-associated left ventricular dysfunction? Think reprogramming first!

John Gierula¹, Haqeel A Jamil, Rowenna Byrom

¹Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, Multidisciplinary Cardiovascular Research Centre, University of Leeds, , Leeds, UK.

Heart (British Cardiac Society)

|January 17, 2014

Summary

This summary is machine-generated.

Reprogramming pacemakers to reduce right ventricular (RV) pacing is safe and improves left ventricular ejection fraction (LVEF) in patients without complete heart block. This optimization enhances cardiac function without negatively impacting quality of life or exercise capacity.

Keywords:

heart failure left ventricular dysfunction pacemaker

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Area of Science:

Cardiology
Biomedical Engineering
Medical Device Technology

Background:

Heart failure and left ventricular systolic dysfunction (LVSD) are prevalent in patients with permanent pacemakers.
The role of right ventricular (RV) pacing in exacerbating cardiac dysfunction is debated, particularly in patients with pre-existing cardiac conditions.

Purpose of the Study:

To evaluate the safety and efficacy of reprogramming pacemakers to minimize RV pacing.
To determine if reducing RV pacing improves cardiac function in patients without complete heart block.

Main Methods:

A prospective service evaluation was conducted on 66 patients attending a pacemaker clinic.
Pacemaker programming was optimized to avoid RV pacing.
Key outcomes measured included left ventricular ejection fraction (LVEF), NT-pro-BNP levels, quality of life, and exercise capacity at baseline and after 6 months.

Main Results:

RV pacing was reduced by a mean of 49% after 6 months.
A significant mean improvement of 6% in LVEF was observed.
No significant changes were noted in exercise capacity, NT-pro-BNP levels, or quality of life.

Conclusions:

Reprogramming pacemakers to avoid RV pacing is a safe strategy.
This intervention is associated with improved left ventricular function, directly related to the reduction in RV pacing.
Patient symptoms and quality of life were not adversely affected.