Evaluation of Long Term Effect of RV Apical Pacing on Global LV Function by Echocardiography

Sarkar, Narayan Chandra; Tilkar, Mahendra; Jain, Siddhant; Mondal, Subrata Kumar; Sarkar, Prasanta Kumar; Modi, Nitin

doi:10.7860/jcdr/2016/18547.7397

Cited by 3 publications

(4 citation statements)

References 30 publications

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“…Similar to the results by Ebert et al [15], our study showed that the deterioration in LVEF was gradual and progressive and more in patients who had baseline LV dysfunction. Our findings were in accordance with the study conducted by Sarkar et al [16] which have shown worsening LV diastolic and systolic functions after pacemaker implantation. Our findings were in accordance with the study by Dwivedi et al [17] which showed that diastolic dysfunction develops as early as first week after pacemaker implantation.…”

Section: Discussionsupporting

confidence: 94%

Chronology of cardiac dysfunction after permanent pacemaker implantation: an observational 2 year prospective study in North India

Gupta¹,

Showkat²,

Aslam³

et al. 2021

Int J Arrhythm

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Background The purpose of this study is to evaluate cardiac functions using transthoracic echocardiography, change in lead parameters and electrocardiogram (ECG) morphology in patients undergoing permanent pacemaker implantation over a follow-up period of 6 months. Methods This is a prospective study in patients undergoing permanent pacemaker implantation in a tertiary care hospital. Patients undergoing permanent pacemaker implantation were enrolled for up to one year and Echocardiographic parameters (by 2 blind operators) and ECG parameters were recorded at admission (within 24 h), before discharge (within 7 days of pacemaker implantation), after 1 month (± 7 days) and after 6 months (± 7 days) of follow-up. Results A total of 96 patients (60.4% males and 39.6% female, mean age 66.65 years) were implanted with permanent pacemaker. The mean QRS duration was 133.18 ms and increased significantly to 146.03 ms by 6 months despite septal lead placement in majority (92%) of patients. The mean baseline ejection fraction of 51.47 decreased significantly to 47.83 by 6 months. Diastolic parameters like left atrial volume index, early to late diastolic transmitral flow velocity (E/A) and early diastolic mitral annular tissue velocity (E/e′) showed a significant increase (> 5%) from baseline by the end of first week. By the end of first month, systolic dysfunction of RV sets in with significant (> 5%) change from baseline in parameters like Right ventricle myocardial performance index, transannular plane systolic excursion and right ventricle systolic excursion velocity (RVS′). Conclusion We have observed that pacemaker recipients with baseline reduced left ventricle (LV) systolic functions perform significantly worse compared to those with baseline normal cardiac functions and had a higher rate of deterioration of LV function. RV dysfunction is the first abnormality that occurs, by 1 week followed by LV dysfunction which starts by 1 month and the diastolic dysfunctions precede the systolic dysfunction. QRS duration also showed a gradual increase despite septal lead placement in majority (92%) and lead parameters showed no significant change over 6 months.

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Section: Discussionsupporting

confidence: 94%

Chronology of cardiac dysfunction after permanent pacemaker implantation: an observational 2 year prospective study in North India

Gupta¹,

Showkat²,

Aslam³

et al. 2021

Int J Arrhythm

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“…The development of pacing induced cardiomyopathy with severe LV impairment before her second pregnancy was an unfortunate, but well-described complication of long-term pacing in the young, which responded to resynchronisation therapy. 7,8 This case highlights the benefit of multidisciplinary teams looking after pregnant women with cardiovascular disease. The ESC guidelines on the management of cardiovascular disease in pregnancy recognise this and emphasise the value of a pregnancy heart team for all women at moderate or high risk of complications during pregnancy.…”

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Management and complications of complete heart block in pregnancy

et al. 2021

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“…In juvenile dogs, prolonged ectopic pacing resulted in CM damage including myofibrillar disarray (Karpawich et al, 1990). Long-term right ventricular apical pacing in adult patients generated electrical dyssynchrony, leading to LV remodeling and dysfunction (Sarkar et al, 2016). Thus, the role of chronic pacing and the underlying cellular and molecular mechanisms affecting maturation remain unknown.…”

Section: Discussionmentioning

confidence: 99%

Quantification of Cardiomyocyte Alignment from Three-Dimensional (3D) Confocal Microscopy of Engineered Tissue

et al. 2017

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Biological tissues have complex, three-dimensional (3D) organizations of cells and matrix factors that provide the architecture necessary to meet morphogenic and functional demands. Disordered cell alignment is associated with congenital heart disease, cardiomyopathy, and neurodegenerative diseases and repairing or replacing these tissues using engineered constructs may improve regenerative capacity. However, optimizing cell alignment within engineered tissues requires quantitative 3D data on cell orientations and both efficient and validated processing algorithms. We developed an automated method to measure local 3D orientations based on structure tensor analysis and incorporated an adaptive subregion size to account for multiple scales. Our method calculates the statistical concentration parameter, κ, to quantify alignment, as well as the traditional orientational order parameter. We validated our method using synthetic images and accurately measured principal axis and concentration. We then applied our method to confocal stacks of cleared, whole-mount engineered cardiac tissues generated from human-induced pluripotent stem cells or embryonic chick cardiac cells and quantified cardiomyocyte alignment. We found significant differences in alignment based on cellular composition and tissue geometry. These results from our synthetic images and confocal data demonstrate the efficiency and accuracy of our method to measure alignment in 3D tissues.

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Evaluation of Long Term Effect of RV Apical Pacing on Global LV Function by Echocardiography

Cited by 3 publications

References 30 publications

Chronology of cardiac dysfunction after permanent pacemaker implantation: an observational 2 year prospective study in North India

Chronology of cardiac dysfunction after permanent pacemaker implantation: an observational 2 year prospective study in North India

Management and complications of complete heart block in pregnancy

Quantification of Cardiomyocyte Alignment from Three-Dimensional (3D) Confocal Microscopy of Engineered Tissue

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