Predictors of Right ventricular Pacing induced Left Ventricular dysfunction in Pacemaker Recipients With Preserved Ejection Fraction

Abstract

Pacemaker implantation for patients with brady-arrhythmia is widely used as recommended by current guidelines to reduce cardiac morbidity and mortality. Chronic RV pacing may cause electrical and mechanical dyssynchrony which lead finally to reduce left ventricular ejection fraction. This deterioration of LVEF has been defined as pacemaker induced cardiomyopathy after all other causes of reduced LVEF could be excluded. The incidence of PICM was described by many studies and ranged between 10 to 26 %.The predictors for PICM occurrence has not been well studied. These studies were limited by variation in follow-up period and definition of PICM. The current study was undertaken to study the incidence and predictors of PICM in patients who underwent pacemaker implantation in Ain shams University hospital. The study included 160 patients who had single or dual chamber pacemaker implantation between 2010 and 2017 and all patients had Personal history taking, Past medical history, Analysis of the complaint (if present) and clinical examination, Standard 12-lead surface ECG before and after device implantation, Transthoracic echocardiography before and after device implantation, Chest x-ray after pacemaker implantation and Device interrogation.