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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
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Impact and Modifiers of Ventricular Pacing in Patients With Single Ventricle Circulation
Henry Chubb1, Anica Bulic2, Douglas Mah3
1Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Stanford, California, USA; Division of Pediatric Cardiothoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, Stanford, California, USA.
Journal of the American College of Cardiology
|August 25, 2022
Summary
Permanent ventricular pacing in single ventricle patients increases the risk of death or transplant. Higher pacing percentages, QRS scores, and nonapical lead positions are linked to worse outcomes.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Electrophysiology
Background:
- Single ventricle (SV) palliation carries lifelong complications.
- Permanent ventricular pacing (PPMv) may worsen long-term outcomes in SV patients.
Purpose of the Study:
- Quantify the attributable risk of PPMv in SV patients.
- Identify modifiable risk factors associated with PPMv in SV.
Main Methods:
- International study with data from 22 centers across 9 countries.
- Matched 1:1 cohort study comparing SV patients with PPMv to controls.
- Primary outcome: death or heart transplantation.
Main Results:
- 236 PPMv subjects and 213 controls identified; median follow-up 6.9 years.
- PPMv associated with a 3.8-fold increased risk of death/transplant (HR 3.8, P < 0.001).
- Higher ventricular pacing (Vp), QRS z-score, and nonapical lead position increased adverse event risk.
Conclusions:
- PPMv in SV patients significantly increases the risk of heart transplantation and death.
- Increased Vp, QRS z-score, and nonapical lead position are modifiable risk factors for adverse outcomes.
Keywords:
FontanGlenncardiac resynchronization therapycardiac transplantcongenital heart diseaseelectrical dyssynchronyheart failurepediatricsingle ventricleMore Related Videos
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