Related Experiment Video
Updated: Feb 28, 2026
10:17
Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
2.0K
Advanced Cardiac Imaging for Risk Prediction of Pacing-Induced Cardiomyopathy: A Narrative Literature Review
Karla Asturias1, Sarah Li1, Shivani Reddy2
1Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR 97239, USA.
Journal of Clinical Medicine
|February 27, 2026
Summary
Noninvasive cardiac imaging can identify patients at risk for pacing-induced cardiomyopathy (PICM) before symptoms arise. Echocardiography and cardiac MRI help predict heart failure and guide pacing strategies to mitigate PICM risk.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Pacing-induced cardiomyopathy (PICM) is a frequent complication of right ventricular (RV) pacing, linked to dyssynchrony.
- Existing risk factors for PICM have limited predictive accuracy.
- PICM encompasses various forms, including heart failure with preserved ejection fraction and RV failure.
Purpose of the Study:
- To review current evidence on noninvasive imaging for identifying patients at high risk of PICM.
- To explore the role of cardiac imaging in predicting and managing PICM.
- To summarize imaging techniques for early PICM detection.
Main Methods:
- Comprehensive literature search of PubMed, Scopus, Google Scholar, and Cochrane databases (2000-2025).
- Inclusion of randomized controlled trials, observational studies, guidelines, and systematic reviews.
- Keywords included RV pacing, PICM, echocardiography, CT, and cardiac MRI.
Main Results:
- Cardiac imaging is crucial for diagnosing PICM and detecting at-risk patients pre-symptomatically.
- 2D/3D echocardiography with global longitudinal strain can detect early PICM development.
- Cardiac MRI accurately assesses volumes, synchrony, and quantifies myocardial fibrosis, a PICM predictor.
Conclusions:
- Pre-implantation cardiac imaging can predict heart failure risk and guide pacing modality selection.
- An imaging-guided approach can advance PICM management.
- Noninvasive imaging offers sensitive parameters for PICM risk stratification.
Related Concept Videos
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
568
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...
568
01:25Cardiomyopathy I: Introduction and Classification
700
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...
700
01:30Cardiomyopathy II: Dilated Cardiomyopathy
667
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,...
667
01:29Cardiomyopathy V: Interprofessional Care
542
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
542
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
655
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...
655
01:30Acute Coronary Syndrome III: Diagnostic Studies
338
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
338