Comparison of Global Longitudinal Strain in Dual-chamber versus Ventricular Pacemaker in Complete Heart Block

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Imaging

Background:

• Total atrioventricular block (TAVB) necessitates permanent pacemaker implantation (PPM).
• Dual-chamber (DDD) pacing is theoretically more physiological than ventricular (VVI) pacing, but clinical superiority remains unproven.
• Assessing left ventricular (LV) function using global longitudinal strain (GLS) is crucial for evaluating pacing modes.

Purpose of the Study:

• To compare the effects of DDD versus VVI pacing on LV function in TAVB patients.
• To evaluate changes in GLS at 1 and 3 months post-PPM implantation.

Main Methods:

• A comparative study of adult TAVB patients undergoing PPM implantation.
• Echocardiographic GLS measurements were taken before, and 1 and 3 months after PPM.
• 43 patients meeting inclusion criteria were analyzed, comparing DDD and VVI pacing modes.

Main Results:

• No significant baseline differences were observed between DDD and VVI groups.
• Significant GLS deterioration occurred 1 month post-PPM in the VVI group (P=0.002).
• No significant GLS changes were observed in the DDD group, even at 3 months (P=0.055).

Conclusions:

• DDD pacing demonstrates short-term superiority in preserving LV function in TAVB patients post-PPM.
• These findings suggest DDD pacing may be advantageous for maintaining cardiac mechanics in TAVB.
• Further long-term studies are warranted to confirm these benefits.