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Prognostic factors of pacing-induced cardiomyopathy

Hong Zhang1, Yu-Jie Zhou2, Yu-Jie Zeng1

  • 1Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

Chinese Medical Journal
|June 23, 2020
PubMed

Insights

Pacing-induced cardiomyopathy (PICM) can lead to heart failure. This study identified paced QRS duration and ventricular pacing percentage as key indicators to predict PICM development in patients receiving pacemakers.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Right ventricular pacing can negatively impact left ventricular function, potentially leading to heart failure.
  • Pacing-induced cardiomyopathy (PICM) is a clinical concern associated with pacemaker use.
  • Identifying patients at risk for PICM before pacemaker implantation is crucial.

Purpose of the Study:

  • To validate prognostic factors for predicting the development of pacing-induced cardiomyopathy (PICM).
  • To identify patients with a higher susceptibility to PICM before pacemaker implantation.

Main Methods:

  • An observational study included 256 patients, with 23 developing PICM within one year.
  • Cox proportional hazard models were used to analyze prognostic factors for PICM.
  • Dose-response analysis evaluated the relationship between significant indicators and PICM development.

Main Results:

  • Male sex, longer paced QRS duration, and higher ventricular pacing percentage were independent predictors of PICM.
  • Specifically, a 1 ms increase in paced QRS duration (HR: 1.95) and a 1% increase in ventricular pacing (HR: 1.65) were significantly associated with PICM.
  • Dose-response analysis confirmed a positive association between ventricular pacing percentage, paced QRS duration, and PICM.

Conclusions:

  • Paced QRS duration and ventricular pacing percentage are the most sensitive prognostic factors for predicting PICM.
  • These factors can aid in identifying patients at higher risk for developing cardiomyopathy due to pacemaker use.
Abstract

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