Heart failure and right ventricular pacing – how to avoid the need for cardiac resynchronization therapy

Paton, Maria F.; Witte, Klaus K.

doi:10.1080/17434440.2019.1552133

Cited by 1 publication

(2 citation statements)

References 77 publications

(81 reference statements)

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“…The pacemaker releases electrical pulses through pulse generators and stimulates myocardial contraction. In recent years, the indications for pacemaker implantation have been expanded to include vasovagal syncope, paroxysmal atrial fibrillation, refractory congestive heart failure, and hypertrophic cardiomyopathy [ 1 ]. However, the implantation of permanent pacemakers has been reported to affect the hemodynamics of patients, and the right ventricular apical pacing leads to the left and right ventricular asynchronous contraction and may even induce or aggravate the chronic heart failure.…”

Section: Introductionmentioning

confidence: 99%

“…However, the implantation of permanent pacemakers has been reported to affect the hemodynamics of patients, and the right ventricular apical pacing leads to the left and right ventricular asynchronous contraction and may even induce or aggravate the chronic heart failure. Therefore, after the implantation of permanent pacemaker, clinicians should focus on the improvement of cardiac function [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Metoprolol Improves Myocardial Remodeling and Cardiac Function in Patients with Permanent Pacemaker Implantation

Hu²,

et al. 2022

Journal of Healthcare Engineering

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In China, the incidence of arrhythmia has also increased to approximately 20% of all cardiovascular diseases. The incidence of cardiovascular diseases in China has certain characteristics, which are generally low in the south and high in the north, and they tend to be younger and growing. Permanent pacemaker implantation is currently the most effective means of treating arrhythmia and preventing sudden death. To explore the clinical application value of metoprolol in patients after permanent pacemaker implantation. Ninety patients with permanent dual-chamber pacemaker implantation in our hospital are selected and divided into a metoprolol group and a control group according to whether metoprolol is used one week after the operation and 45 patients in each group. After one postoperative week, the LVEF%, LVEDd, LAD, and E/A of the metoprolol and the control groups had no statistically significant differences p > 0.05 . Twelve months postoperatively, the E/A of the metoprolol group is higher than that of the control group p < 0.05 , and LVEDd and LAD are lower than those of the control group (P < 0.05). The NT-proBNP and hs-CRP levels between the metoprolol and control groups had no significant differences p > 0.05 in the values recorded immediately postoperatively. The NT-proBNP of the metoprolol group is lower than that of the control group p < 0.05 at 12 months following pacemaker implantation. At one week after surgery, QTd, Pd, and Tp-Te are not significantly different (P > 0.05) between the metoprolol group and the control group, whereas the QTd and Pd times in the metoprolol group are lower than those in the control group p < 0.05 at the 12-month follow-up. At one week postoperatively, the SDNN, SDANN, and RMSSD between the metoprolol and control groups did not show any statistically significant differences p > 0.05 . The SDANN of the metoprolol group is higher than that in the control group p < 0.05 in the 12-month evaluation. One week after the operation, the serum IL-6 and TNF-α levels are not significantly different between the metoprolol and control groups p > 0.05 . At 12 months after surgery, the serum IL-6 and TNF-α levels in the metoprolol group are lower than those in the control group p < 0.05 . The incidence of adverse events in the metoprolol group is 9.30% lower than 26.83% in the control group within 12 months after the operation p < 0.05 . The use of metoprolol in patients with permanent pacemaker implantation after surgery can reduce the expansionary remodeling of the left atrium and have less impact on the QT-dispersion and Pd time.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%