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The development of pacing induced ventricular dysfunction is influenced by the underlying structural heart defect in

Seshadri Balaji1, Narayanswami Sreeram2

  • 1Departments of Pediatrics (Cardiology), Oregon Health & Science University, Portland, OR, United States.

Indian Heart Journal
|May 3, 2017
PubMed

Insights

Pacing-induced ventricular dysfunction (PIVD) affects some children after congenital heart disease (CHD) surgery, but not all. Prolonged QRS duration did not predict PIVD, warranting further investigation into specific CHD types.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Electrophysiology
  • Congenital Heart Disease

Background:

  • Right ventricular pacing can lead to pacing-induced ventricular dysfunction (PIVD).
  • PIVD is often reversible with biventricular pacing (BiVP).
  • Factors contributing to PIVD in pediatric patients are not well understood.

Purpose of the Study:

  • To investigate the incidence and associated factors of PIVD in children with congenital heart disease (CHD) after pacemaker implantation.
  • To determine if prolonged QRS duration is linked to PIVD in this population.

Main Methods:

  • Retrospective review of children under 2 years old who received epicardial dual-chamber pacemakers post-CHD surgery.
  • PIVD defined as % fractional shortening <15%, improving after BiVP.
  • Analysis of PIVD occurrence across different CHD subtypes and correlation with QRS duration.

Main Results:

  • 19% (9 of 47) of children developed PIVD.
  • PIVD incidence varied among CHD types, with higher rates in atrioventricular canal defects and double outlet right ventricles.
  • Prolonged QRS duration was not associated with PIVD; patients with PIVD showed significantly lower % fractional shortening while paced.

Conclusions:

  • PIVD occurs in specific congenital heart disease subtypes following right ventricular pacing.
  • Prolonged QRS duration is not a predictor of PIVD in these patients.
  • Further research is needed to understand the predilection for PIVD in certain CHD types.
Abstract

Keywords:
ChildrenComplete heart blockCongenital heart diseasePacemakerPacing induced cardiomyopathy

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