Effects of long-term right ventricular apex pacing on left ventricular dyssynchrony, morphology and systolic function

M, Xin; Gao, Peng; Zhang, Shuyang

doi:10.1016/j.ijcard.2021.01.042

Cited by 2 publications

(1 citation statement)

References 63 publications

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“…According to Xin et al [46], who conducted an almost 10-year follow-up of RVA pacing in patients with normal LV function, long-term RVA pacing significantly increased ventricular dyssynchrony and TR degree. In our study, which had a shorter follow-up period, we did not observe any difference in the occurrence of dyssynchrony between both groups or any impact on the progression of TR.…”

Section: Discussionmentioning

confidence: 99%

Impact of lead position on tricuspid regurgitation, ventricular function, and heart failure exacerbation and mortality after cardiac implantable electronic device implantation. Preliminary results from the PACE-RVTR Registry

Chodór-Rozwadowska,

Sawicka,

Morawski

et al. 2024

Polish Heart J

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Background:The most frequent mechanism of lead-related tricuspid regurgitation (LRTR), which occurs in 7.2% to 44.7% of patients implanted with a cardiac implantable electronic device (CIED), is leaflet impingement or the restriction of its movement by a ventricular lead. It is unclear if the position of the lead tip -in the right ventricular apex (RVA) or other location (non-RVA) -has any influence on the development of LRTR. The study aimed to determine the impact of the CIED lead tip position on the development or progression of tricuspid regurgitation (TR) and its potential impact on heart failure exacerbation and mortality.Methods: One hundred and two consecutive patients who received CIEDs between March 2020 and October 2021 were included in the prospective registry (PACE-RVTR). Patients were assigned to two groups depending on the lead position -the RVA group and the non-RVA group. All patients underwent echocardiographic evaluation before implantation and one year later. Results:In terms of baseline clinical characteristics, the two groups did not differ. Before CIED implantation, patients in the non-RVA group had better left ventricular systolic function (P = 0.004). Pacemakers were implanted more often in the non-RVA group (P = 0.001) while implantable cardioverter-defibrillators in the RVA group (P = 0.008). Progression to severe or massive TR was more common in the non-RVA group (P = 0.005). Conclusion:Severe and massive TR occurred more often in patients with the non-RVA position of the lead. The right ventricular lead position did not impact heart failure progression or all-cause mortality at two-year follow-up.

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Section: Discussionmentioning

confidence: 99%

Impact of lead position on tricuspid regurgitation, ventricular function, and heart failure exacerbation and mortality after cardiac implantable electronic device implantation. Preliminary results from the PACE-RVTR Registry

Chodór-Rozwadowska,

Sawicka,

Morawski

et al. 2024

Polish Heart J

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Left bundle branch pacing better preserves ventricular mechanical synchrony than right ventricular pacing: a two-centre study

Mao,

Duchenne,

Yang

et al. 2023

European Heart Journal - Cardiovascular Imaging

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Aims Left bundle branch pacing (LBBP) has been shown to better maintain electrical synchrony compared with right ventricular pacing (RVP), but little is known about its impact on mechanical synchrony. This study investigates whether LBBP better preserves left ventricular (LV) mechanical synchronicity and function compared with RVP. Methods and results Sixty patients with pacing indication for bradycardia were included: LBBP (n = 31) and RVP (n = 29). Echocardiography was performed before and shortly after pacemaker implantation and at 1-year follow-up. The lateral wall–septal wall (LW–SW) work difference was used as a measure of mechanical dyssynchrony. Septal flash, apical rocking, and septal strain patterns were also assessed. At baseline, LW–SW work difference was small and similar in two groups. SW was markedly decreased, while LW work remained mostly unchanged in RVP, resulting in a larger LW–SW work difference compared with LBBP (1253 ± 687 mmHg·% vs. 439 ± 408 mmHg·%, P < 0.01) at last follow-up. In addition, RVP more often induced septal flash or apical rocking and resulted in more advanced strain patterns compared with LBBP. At 1 year follow-up, LV ejection fraction (EF) and global longitudinal strain (GLS) were more decreased in RVP compared with LBBP (ΔLVEF: −7.4 ± 7.0% vs. 0.3 ± 4.1%; ΔLVGLS: −4.8 ± 4.0% vs. −1.4 ± 2.5%, both P < 0.01). In addition, ΔLW–SW work difference was independently correlated with LV adverse remodelling (r = 0.42, P < 0.01) and LV dysfunction (ΔLVEF: r = −0.61, P < 0.01 and ΔLVGLS: r = −0.38, P = 0.02). Conclusion LBBP causes less LV mechanical dyssynchrony than RVP as it preserves a more physiologic electrical conduction. As a consequence, LBBP appears to preserve LV function better than RVP.

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Effects of long-term right ventricular apex pacing on left ventricular dyssynchrony, morphology and systolic function

Cited by 2 publications

References 63 publications

Impact of lead position on tricuspid regurgitation, ventricular function, and heart failure exacerbation and mortality after cardiac implantable electronic device implantation. Preliminary results from the PACE-RVTR Registry

Impact of lead position on tricuspid regurgitation, ventricular function, and heart failure exacerbation and mortality after cardiac implantable electronic device implantation. Preliminary results from the PACE-RVTR Registry

Left bundle branch pacing better preserves ventricular mechanical synchrony than right ventricular pacing: a two-centre study

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