Title

Impact of the permanent ventricular pacing site on left ventricular function in children: a retrospective multicentre survey.

Document Type

Article

Publication Date

12-2011

Identifier

DOI: 10.1136/heartjnl-2011-300197

Abstract

BACKGROUND: Chronic right ventricular (RV) pacing is associated with deleterious effects on cardiac function.

OBJECTIVE: In an observational multicentre study in children with isolated atrioventricular (AV) block receiving chronic ventricular pacing, the importance of the ventricular pacing site on left ventricular (LV) function was investigated.

METHODS: Demographics, maternal autoantibody status and echocardiographic measurements on LV end-diastolic and end-systolic dimensions and volumes at age(>1 year) for isolated AV block. LV fractional shortening (LVFS) and, if possible LV ejection fraction (LVEF) were calculated. Linear regression analyses were adjusted for patient characteristics.

RESULTS: From 27 centres, 297 children were included, in whom pacing was applied at the RV epicardium (RVepi, n = 147), RV endocardium (RVendo, n = 113) or LV epicardium (LVepi, n = 37). LVFS was significantly affected by pacing site (p = 0.001), and not by maternal autoantibody status (p = 0.266). LVFS in LVepi (39 ± 5%) was significantly higher than in RVendo (33 ± 7%, p < 0.001) and RVepi (35 ± 8%, p = 0.001; no significant difference between RV-paced groups, p = 0.275). Subnormal LVFS (LVFS < 28%) was seen in 16/113 (14%) RVendo-paced and 21/147 (14%) RVepi-paced children, while LVFS was normal (LVFS ≥ 28%) in all LVepi-paced children (p = 0.049). These results are supported by the findings for LVEF (n = 122): LVEF was

CONCLUSION: In children with isolated AV block, permanent ventricular pacing site is an important determinant of LV function, with LVFS being significantly higher with LV pacing than with RV pacing.

Journal Title

Heart (British Cardiac Society)

Volume

97

Issue

24

First Page

2051

Last Page

2055

MeSH Keywords

Adolescent; Atrioventricular Block; Cardiac Pacing, Artificial; Child; Child, Preschool; Echocardiography; Electrocardiography; Female; Follow-Up Studies; Humans; Male; Retrospective Studies; Stroke Volume; Treatment Outcome; Ventricular Dysfunction, Left; Ventricular Function, Left

Keywords

Atrioventricular Block; Artificial Cardiac Pacing; Echocardiography; Electrocardiography; Follow-Up Studies; Retrospective Studies; Stroke Volume; Treatment Outcome; Ventricular Dysfunction, Left; Ventricular Function, Left

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