BACKGROUND: Right ventricular pacing may be deleterious in patients with left ventricular dysfunction, but in patients with normal function the impact of this stimulation triggering clinically relevant ventricular dysfunction is not fully established. OBJECTIVES: To evaluate the clinical, echocardiographic findings of patients with previously normal left ventricular function underwent implantation of a pacemaker. METHODS: Observational, cross-sectional study with 20 patients, who underwent implantation of pacemaker, prospectively followed-up, with the following inclusion criteria: normal left ventricular function defined by echocardiography and ventricular pacing higher than 90%. Were evaluated functional class (FC) (New York Heart Association), 6-minute walk test (6MWT), B-type natriuretic peptide (BNP), echocardiographic assessment (conventional and dyssynchrony parameters), and quality of life questionnaire (QLQ) (SF-36). The assessment was performed at ten days (t1), four months (t2), eight months (t3), 12 months (t4) and 24 months (t5). RESULTS: Conventional echocardiographic parameters and dyssynchrony parameters showed statistically significant variation over time. The 6MWT, FC, and BNP showed worsening at the end of two years. QLQ showed initial improvement and worsening at the end of two years. CONCLUSION: The implantation of conventional pacemaker was associated with worsening in functional class, worsening in walk test, increased BNP levels, increased duration of QRS, and worsening in some domains of the QLQ at the end of two years. There were no changes in echocardiography measurements (conventional and asynchrony measures).
BACKGROUND: Right ventricular pacing may be deleterious in patients with left ventricular dysfunction, but in patients with normal function the impact of this stimulation triggering clinically relevant ventricular dysfunction is not fully established. OBJECTIVES: To evaluate the clinical, echocardiographic findings of patients with previously normal left ventricular function underwent implantation of a pacemaker. METHODS: Observational, cross-sectional study with 20 patients, who underwent implantation of pacemaker, prospectively followed-up, with the following inclusion criteria: normal left ventricular function defined by echocardiography and ventricular pacing higher than 90%. Were evaluated functional class (FC) (New York Heart Association), 6-minute walk test (6MWT), B-type natriuretic peptide (BNP), echocardiographic assessment (conventional and dyssynchrony parameters), and quality of life questionnaire (QLQ) (SF-36). The assessment was performed at ten days (t1), four months (t2), eight months (t3), 12 months (t4) and 24 months (t5). RESULTS: Conventional echocardiographic parameters and dyssynchrony parameters showed statistically significant variation over time. The 6MWT, FC, and BNP showed worsening at the end of two years. QLQ showed initial improvement and worsening at the end of two years. CONCLUSION: The implantation of conventional pacemaker was associated with worsening in functional class, worsening in walk test, increased BNP levels, increased duration of QRS, and worsening in some domains of the QLQ at the end of two years. There were no changes in echocardiography measurements (conventional and asynchrony measures).
Authors: Fabiana S Machado; Linda A Jelicks; Louis V Kirchhoff; Jamshid Shirani; Fnu Nagajyothi; Shankar Mukherjee; Randin Nelson; Christina M Coyle; David C Spray; Antonio C Campos de Carvalho; Fangxia Guan; Cibele M Prado; Michael P Lisanti; Louis M Weiss; Susan P Montgomery; Herbert B Tanowitz Journal: Cardiol Rev Date: 2012 Mar-Apr Impact factor: 2.644
Authors: Andrew E Epstein; John P Dimarco; Kenneth A Ellenbogen; N A Mark Estes; Roger A Freedman; Leonard S Gettes; A Marc Gillinov; Gabriel Gregoratos; Stephen C Hammill; David L Hayes; Mark A Hlatky; L Kristin Newby; Richard L Page; Mark H Schoenfeld; Michael J Silka; Lynne Warner Stevenson; Michael O Sweeney Journal: Heart Rhythm Date: 2008-05-19 Impact factor: 6.343
Authors: N B Schiller; P M Shah; M Crawford; A DeMaria; R Devereux; H Feigenbaum; H Gutgesell; N Reichek; D Sahn; I Schnittger Journal: J Am Soc Echocardiogr Date: 1989 Sep-Oct Impact factor: 5.251
Authors: Jing Ping Sun; Edward Chinchoy; Erwan Donal; Zoran B Popović; George Perlic; Craig R Asher; Neil L Greenberg; Richard A Grimm; Bruce L Wilkoff; James D Thomas Journal: J Am Soc Echocardiogr Date: 2004-08 Impact factor: 5.251