Bi-Ventricular Pacing Upgrade Dramatically Increases Ejection Fraction and Functional Status Despite no Significant Decrease in Qrs Duration

Abstract

Background: Angiotensin converting enzyme inhibitor (ACEi) and beta-blocker (BB) medications are indicated in patients with impaired left ventricular (LV) systolic function. These medications result in improved prognosis, quality of life and LV function, with a proportion of complete recovery of LV systolic function. The proportion of patients who require life-long medication use for indications other than previous LV dysfunction is unclear.Methods: We conducted a retrospective analysis of 1400 cardiology patients treated at Princess Alexandra Hospital, Brisbane, up to 2014. Data collected include, patient demographics, medical history, medication use, imaging results and clinical outcomes.Results: 1400 cardiology medical records were evaluated. Significantly impaired LV systolic function (LV EF ≤ 40%) was noted in 559 patients (39.9%) at the beginning of their medical treatment, of which 173 patients had no coronary artery disease and were still alive in 12 months. In the nonischaemic cases, recovery of LV systolic function was noted in 27.7%, the majority of which had indications for ACEi and BB use other than previous cardiomyopathy. Only 18 out of 559 patients (3.2%) with history of LV impairment has previous non-ischaemic cardiomyopathy as sole indications for ongoing ACEi and BB use. Conclusion:Only a very small proportion of patients have previous non-ischaemic cardiomyopathy as sole indication for on-going ACEi and BB use. Most other patients have additional disease indications for continuing these medications.