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Effects of permanent cardiac pacemaker implantation on vascular endothelial function, blood coagulation and cardiac
Xinling Zhang1, Yan Li1, Nan Wang2
1The Heart Center, Jining First People's Hospital, Jining, Shandong 272011, P.R. China.
Insights
Pacemaker implantation in bradycardia patients impacts blood coagulation and cardiac function. Dual-chamber (DDD) pacemakers show improved cardiac function and quality of life compared to ventricular inhibited (VVI) types.
Area of Science:
- Cardiology
- Vascular Biology
- Hematology
Background:
- Bradycardia necessitates pacemaker implantation, potentially affecting physiological functions.
- Understanding the impact of pacemakers on vascular endothelial function and blood coagulation is crucial for patient management.
Purpose of the Study:
- To investigate changes in vascular endothelial function, blood coagulation, and cardiac function after permanent pacemaker implantation in bradycardia patients.
- To compare the effects of different pacemaker types (DDD vs. VVI) on these parameters and patient quality of life.
Main Methods:
- Prospective study involving 117 bradycardia patients and 53 healthy controls.
- Measurement of coagulation factors (FVIII:C, vWF, AT:A, D-D, TM, TF, FIB) and cardiac function indexes (LVEF, LVESV) before and after pacemaker implantation.
- Comparison between different pacemaker groups (DDD vs. VVI) and with a control group.
Main Results:
- Pacemaker implantation significantly altered coagulation and cardiac function indexes compared to controls.
- Post-implantation, patients showed increased FVIII:C, vWF, FIB, D-D, TF, and LVESV, with decreased LVEF.
- DDD pacemakers demonstrated superior cardiac function (higher LVEF, lower LVESV) and better quality of life than VVI pacemakers.
Conclusions:
- Permanent pacemaker implantation in bradycardia patients affects vascular endothelial function, blood coagulation, and cardiac performance.
- DDD pacemakers are associated with improved cardiac function and quality of life compared to VVI pacemakers, potentially reducing complications.
Abstract:
Changes in vascular endothelial function, blood coagulation and cardiac function indexes after the implantation of a permanent cardiac pacemaker in patients with bradycardia were investigated. A total of 53 healthy people and 117 patients with bradycardia in Jining First People's Hospital from January 2015 to August 2017 were selected. Factor VIII: coagulation (FVIII:C), von Willebr and factor (vWF), antithrombin activity (AT:A), D-dimmer (D-D), thrombomodulin (TM), tissue factor (TF), left ventricular ejection fraction (LVEF) and left ventricular end-systolic volume (LVESV) in the non-pacemaker group and the pacemaker group were significantly different from those in the control group (P<0.05), in which FVIII:C, vWF, D-D, TM, TF and LVESV were significantly higher than those in the control group, while LVEFs were significantly lower than that in the control group. After the implantation of a pacemaker, the FVIII:C, vWF, fibrinogen (FIB), D-D, TF and LVESV in patients were significantly higher than those before implantation (P<0.05), while the LVEF was significantly lower than that before implantation (P<0.05). In addition, in different pacemaker groups, there were no significant differences in blood coagulation and vascular endothelial indexes, but differences in cardiac function levels were obvious, in which LVEF in dual-chamber (DDD) pacemaker group was significantly higher than that in ventricular inhibited (VVI) pacemaker group, and LVESV in the former was significantly lower than that in the latter (P<0.05). Finally, here was no significant difference in the quality of life of patients implanted with different pacemakers (P>0.05), but the quality of life of patients in the DDD pacemaker group was better than that of patients in the VVI group. Therefore, implanting pacemakers in patients with bradycardia affects vascular endothelial function, blood coagulation, and cardiac function indexes in patients, and complications become less after the implantation of DDD pacemakers.
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