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Late deterioration of left ventricular function after right ventricular pacemaker implantation
Bellmann, Barbara ;  Muntean, Bogdan G. ;  Lin, Tina ;  Gemein, Christopher ;  Schmitz, Kathrin ;  Schauerte, Patrick

HaupttitelLate deterioration of left ventricular function after right ventricular pacemaker implantation
AutorBellmann, Barbara
AutorMuntean, Bogdan G.
AutorLin, Tina
AutorGemein, Christopher
AutorSchmitz, Kathrin
AutorSchauerte, Patrick
Seitenzahl6 S.
Freie SchlagwörterCRT; pacemaker-mediated cardiomyopathy; pacemaker; heart failure; LV lead
DDC610 Medizin und Gesundheit
Auch erschienen inAnatolian Journal OF Cardiology. - 16 (2016), 9, Artikel Nr. 678-683
ZusammenfassungObjectives: Right ventricular (RV) pacing induces a left bundle branch block pattern on ECG and may promote heart failure. Patients with dual chamber pacemakers (DCPs) who present with progressive reduction in left ventricular ejection fraction (LVEF) secondary to RV pacing are candidates for cardiac resynchronization therapy (CRT). This study analyzes whether upgrading DCP to CRT with the additional implantation of a left ventricular (LV) lead improves LV function in patients with reduced LVEF following DCP implantation.
Methods: Twenty-two patients (13 males) implanted with DCPs and a high RV pacing percentage (>90%) were evaluated in term of new-onset heart failure symptoms. The patients were enrolled in this retrospective single-center study after obvious causes for a reduced LVEF were excluded with echocardiography and coronary angiography. In all patients, DCPs were then upgraded to biventricular devices. LVEF was analyzed with a two-sided t-test. QRS duration and brain natriuretic peptide (BNP) levels were analyzed with the unpaired t-test.
Results: LVEF declined after DCP implantation from 54±10% to 31±7%, and the mean QRS duration was 161±20 ms during RV pacing. NT-pro BNP levels were elevated (3365±11436 pmol/L). After upgrading to a biventricular device, a biventricular pacing percentage of 98.1±2% was achieved. QRS duration decreased to 108±16 ms and 106±20 ms after 1 and 6 months, respectively. There was a significant increase in LVEF to 38±8% and 41±11% and a decrease in NT-pro BNP levels to 3088±2326 pmol/L and 1860±1838 pmol/L at 1 and 6 months, respectively.
Conclusion: Upgrading to CRT may be beneficial in patients with DCPs and heart failure induced by a high RV pacing percentage. (Anatol J Cardiol 2016; 16: 678-83)
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Fachbereich/EinrichtungMedizinische Fakultät Charité - Universitätsmedizin Berlin
Erscheinungsjahr2016
Dokumententyp/-SammlungenWissenschaftlicher Artikel
SpracheEnglisch
RechteCreative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Anmerkungen des AutorsDer Artikel wurde in einer reinen Open-Access-Zeitschrift publiziert.
Erstellt am31.10.2016 - 12:41:18
Letzte Änderung31.10.2016 - 12:42:08
 
Statische URLhttp://edocs.fu-berlin.de/docs/receive/FUDOCS_document_000000025629
DOI10.5152/AnatolJCardiol.2015.6515
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