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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.

Shaan Khurshid1, David S Frankel2

  • 1Division of Cardiology and Cardiovascular Research Center, Massachusetts General Hospital, Yawkey 5B Heart Center, 55 Fruit Street, Boston, MA 02114, USA.

Cardiology Clinics
|June 15, 2023
PubMed
Summary
This summary is machine-generated.

Right ventricular pacing can cause cardiomyopathy, leading to heart dysfunction in 10-20% of patients. Pacing strategies that maintain synchrony, like biventricular pacing, can prevent or reverse this condition.

Keywords:
Heart failurePacingPacing-induced cardiomyopathy

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure

Background:

  • Right ventricular (RV) pacing-induced cardiomyopathy (PICM) is characterized by left ventricular systolic dysfunction due to pacing-induced dyssynchrony.
  • PICM affects 10-20% of patients with frequent RV pacing.
  • Risk factors include male sex, wide QRS duration, and high RV pacing percentage, yet prediction remains challenging.

Purpose of the Study:

  • To summarize the definition, prevalence, risk factors, and preventive strategies for RV pacing-induced cardiomyopathy.
  • To highlight the role of alternative pacing methods in mitigating RV PICM.

Main Methods:

  • Literature review and synthesis of existing studies on RV pacing-induced cardiomyopathy.
  • Analysis of identified risk factors and outcomes associated with different pacing modalities.

Main Results:

  • RV pacing can lead to significant left ventricular dysfunction.
  • Biventricular pacing and conduction system pacing are effective in preventing PICM.
  • These alternative pacing methods can also reverse established left ventricular systolic dysfunction.

Conclusions:

  • RV pacing-induced cardiomyopathy is a significant clinical concern.
  • Preserving cardiac synchrony through biventricular or conduction system pacing is crucial for preventing and managing RV PICM.
  • Optimizing pacing strategies can improve long-term cardiac outcomes in patients requiring ventricular pacing.