Early pacing-induced systolic dyssynchrony is a strong predictor of left ventricular adverse remodeling: Analysis from the Pacing to Avoid Cardiac Enlargement (PACE) trial

Fang, Fang; Zhang, Qing; Chan, Joseph Yat‐Sun; Omar, Razali; Hussin, Azlan; Chan, Hamish C.K.; Sanderson, John E.; Xie, Jun-Min; Yu, Cheuk‐Man

doi:10.1016/j.ijcard.2012.08.005

Cited by 45 publications

(26 citation statements)

References 51 publications

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“…41 Further analysis showed that the development of pacing-induced systolic dyssynchrony was associated with LVEF reduction and LV adverse remodeling. 5 This trial provided good evidence for a progression of LV remodeling and eventually HF caused by RV pacing which was prevented by biventricular pacing in patients with bradycardia and normal LVEF. Moreover, the potential mechanism of the benefit of biventricular pacing appeared to be related to the correction of systolic dyssynchrony.…”

Section: Evidence Of Biventricular Pacing For Advanced Avb Patients Wmentioning

confidence: 84%

“…An alternative approach is to use a site other than the RV apex in an attempt to reduce pacing-induced ventricular dyssynchrony. 5,23,24 other pacing sites include the RV mid or low septum, the RV inflow tract, the RV outflow tract, and the His bundle region. However, true RV septal pacing and His bundle pacing are limited by the difficulty of achieving stable lead positions.…”

Section: Comparison Of Rv and Biventricular Pacing For Avb Patientsmentioning

confidence: 99%

“…patients with normal LVEF seem more resistant to the adverse effects of RV pacing, 4,5,23 but LV dysfunction is still commonly observed especially in those with frequent and long-term ventricular pacing. 38 However, the depression of LV systolic function can become manifest at an early stage and may persist after the cessation of pacing.…”

Section: Evidence Of Biventricular Pacing For Advanced Avb Patients Wmentioning

confidence: 99%

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Should All Patients With Heart Block Receive Biventricular Pacing?

Fang

Sanderson

2015

Circ: Arrhythmia and Electrophysiology

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Section: Evidence Of Biventricular Pacing For Advanced Avb Patients Wmentioning

confidence: 84%

Section: Comparison Of Rv and Biventricular Pacing For Avb Patientsmentioning

confidence: 99%

Section: Evidence Of Biventricular Pacing For Advanced Avb Patients Wmentioning

confidence: 99%

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Should All Patients With Heart Block Receive Biventricular Pacing?

Fang

Sanderson

2015

Circ: Arrhythmia and Electrophysiology

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“…21,22 Therefore not every patient should be given CRT due to its high cost and relatively high complication …”

Section: Vulnerable Patients In Conventional Pacemaker Indicationsmentioning

confidence: 99%

Cardiac Resynchronisation Therapy and Heart Failure: Persepctive from 5P Medicine

Fang¹,

Jie²,

Luo³

et al. 2015

Cardiac Failure Review

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Chronic heart failure is still a major challenge for healthcare. Currently, cardiac resynchronisation therapy (CRT) has been incorporated into the updated guideline for patients with heart failure, left ventricular ejection fraction ≤35 % and prolonged QRS duration. With 20 years of development, the concept of ‘from bench to bedside’ has been illustrated in the field of CRT. Given the fact that the indications of CRT keep evolving, the role of CRT is not limited to the curative method for heart failure. We therefore summarise with the perspective of 5P medicine – preventive, personalised, predictive, participatory, promotive, to review the benefit of CRT in the prevention of heart failure in those with conventional pacemaker indications, the individualised assessment of patient’s selection, the predictor of responders of CRT, and the obstacles hindering the more application of CRT and the future development of this device therapy.

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“…It occurs in as many as 50% of patients undergoing RV pacing and includes patients with a normal LVEF. 45,46 In the latter, LV dyssynchrony seems to be the most important contributing factor for the detrimental effect of RV pacing. Early pacing-induced systolic dyssynchrony in patients with preserved or abnormal LV systolic function has been shown to predict adverse LV remodeling associated with a reduction in LVEF, increased LV endsystolic volume, and an increase in long-term allcause mortality and heart failure hospitalizations (Figs.…”

Section: Impact Of Left Ventricular Dyssynchronymentioning

confidence: 99%