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Related Concept Videos

Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

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Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

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The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
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Pathophysiology of Cardiac Performance01:29

Pathophysiology of Cardiac Performance

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Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
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Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
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Pacing induced cardiomyopathy.

Faisal M Merchant1, Suneet Mittal2

  • 1Cardiology Division, Emory University School of Medicine, Atlanta, Georgia.

Journal of Cardiovascular Electrophysiology
|November 15, 2019
PubMed
Summary
This summary is machine-generated.

Pacing induced cardiomyopathy (PICM) may occur acutely, not just chronically. Conduction system pacing (CSP) shows promise in preventing this heart condition, offering a new therapeutic approach.

Keywords:
cardiac resynchronization therapycardiomyopathyconduction system pacingdevice upgradedyssynchronyhis bundle pacingleft bundle branch blockpacemaker

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure

Background:

  • Pacing induced cardiomyopathy (PICM) is typically defined by a chronic, high burden of right ventricle (RV) pacing causing a drop in left ventricle ejection fraction (LVEF).
  • Emerging evidence indicates that heart failure symptoms can manifest more acutely following pacemaker implantation.
  • Current definitions may underestimate the adverse effects of RV pacing.

Purpose of the Study:

  • To re-evaluate the definition and incidence of pacing induced cardiomyopathy.
  • To explore the potential of conduction system pacing (CSP) as a preventive strategy for PICM.
  • To discuss the limitations of current PICM definitions and treatments.

Main Methods:

  • Review of recent data on acute heart failure onset after pacemaker implantation.
  • Analysis of the impact of RV pacing burden on left ventricle ejection fraction (LVEF).
  • Exploration of emerging data on conduction system pacing (CSP) for PICM prevention.

Main Results:

  • Some patients develop heart failure symptoms acutely after pacemaker implantation, suggesting current definitions are insufficient.
  • Traditional definitions focusing on LVEF drop may underestimate the prevalence of pacing-related cardiac dysfunction.
  • Conduction system pacing (CSP) is emerging as a potential method to prevent PICM.

Conclusions:

  • PICM may present acutely, necessitating broader diagnostic criteria beyond chronic LVEF decline.
  • Conduction system pacing (CSP) offers a promising alternative to traditional RV pacing for preventing cardiac dysfunction.
  • Further research into CSP is warranted to establish its role in mitigating pacing-induced cardiomyopathy.