Ventricular Function and Long-Term Pacing in Children with Congenital Complete Atrioventricular Block
Objective: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block. Background: Pacing is a well‐accepted therapy for patients with congenital complete atrioventricular block. The long‐term sequela of right ventricular pacing in this populatio...
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| Veröffentlicht in: | Journal of cardiovascular electrophysiology 2007-04, Vol.18 (4), p.373-377 |
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| creator | KIM, JEFFREY J. FRIEDMAN, RICHARD A. EIDEM, BENJAMIN W. CANNON, BRYAN C. ARORA, GAURAV SMITH, E. O'BRIAN FENRICH, ARNOLD L. KERTESZ, NAOMI J. |
| description | Objective: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block.
Background: Pacing is a well‐accepted therapy for patients with congenital complete atrioventricular block. The long‐term sequela of right ventricular pacing in this population has not been well described.
Methods: We performed a cohort study on all patients with congenital complete atrioventricular block who underwent pacemaker implantation at our institution from 1972 to 2004. Patients with associated congenital heart disease or ventricular dysfunction prior to pacemaker implantation were excluded.
Results: A total of 63 patients were included in the study. The median age at pacemaker implantation was 6.5 years, with an average follow‐up of 9.9 years. The cumulative dysfunction free survival at 20 years was 92%. In total, four patients (6%) were noted to develop LV dysfunction an average of 15.1 years after pacemaker implantation. Of 30 patients who were paced for >10 years, only three (10%) developed echocardiographic evidence of LV dysfunction. Right ventricular apex pacing and prolonged QRS duration were found to be predictive of decreased long‐term LV systolic function (P < 0.05).
Conclusions: Left ventricular dysfunction in patients with congenital complete atrioventricular block is a rare finding, even in those who have been paced for more than 10 years. Right ventricular apex pacing and prolonged QRS duration may be associated with decreased ventricular function over time. At this time, with such a low incidence of cardiac dysfunction, right ventricular pacing should be considered an acceptable first‐line therapy in this population. |
| doi_str_mv | 10.1111/j.1540-8167.2006.00741.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70322669</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70322669</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4041-dc9570c0c3db9a5ccbaf97a46f235f2cc46bbdb459ab4aa515ee1787b62438a43</originalsourceid><addsrcrecordid>eNqNkMtO3DAARa2qqLz6C5VX7JLa8SuR2NAAA2hEKwSt1I3lOA54cJzBTsrw93iYEe2y3vhKvudaOgBAjHKcztdFjhlFWYm5yAuEeI6QoDhffQB77w8fU0aUZaQUZBfsx7hACBOO2CewiwWpKGV4D5ifxo_B6smpAM8nr0c7eKh8C-eDv89uTejhD6Wtv4fWw_rBujYYD5_t-ADr1DDejsql2C-dGQ08SWPDn382v7lBPx6CnU65aD5v7wNwd352W19k8--zy_pknmmKKM5aXTGBNNKkbSrFtG5UVwlFeVcQ1hVaU940bUNZpRqqFMPMGCxK0fCCklJRcgCONrvLMDxNJo6yt1Eb55Q3wxSlQKQoOK9SsdwUdRhiDKaTy2B7FV4kRnKtWC7k2qRcm5RrxfJNsVwl9Mv2j6npTfsX3DpNheNN4dk68_Lfw_KqPksh4dkGt3E0q3dchUfJBRFM_rqeyer0ppwJcSN_k1dT15qJ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70322669</pqid></control><display><type>article</type><title>Ventricular Function and Long-Term Pacing in Children with Congenital Complete Atrioventricular Block</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>KIM, JEFFREY J. ; FRIEDMAN, RICHARD A. ; EIDEM, BENJAMIN W. ; CANNON, BRYAN C. ; ARORA, GAURAV ; SMITH, E. O'BRIAN ; FENRICH, ARNOLD L. ; KERTESZ, NAOMI J.</creator><creatorcontrib>KIM, JEFFREY J. ; FRIEDMAN, RICHARD A. ; EIDEM, BENJAMIN W. ; CANNON, BRYAN C. ; ARORA, GAURAV ; SMITH, E. O'BRIAN ; FENRICH, ARNOLD L. ; KERTESZ, NAOMI J.</creatorcontrib><description>Objective: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block.
Background: Pacing is a well‐accepted therapy for patients with congenital complete atrioventricular block. The long‐term sequela of right ventricular pacing in this population has not been well described.
Methods: We performed a cohort study on all patients with congenital complete atrioventricular block who underwent pacemaker implantation at our institution from 1972 to 2004. Patients with associated congenital heart disease or ventricular dysfunction prior to pacemaker implantation were excluded.
Results: A total of 63 patients were included in the study. The median age at pacemaker implantation was 6.5 years, with an average follow‐up of 9.9 years. The cumulative dysfunction free survival at 20 years was 92%. In total, four patients (6%) were noted to develop LV dysfunction an average of 15.1 years after pacemaker implantation. Of 30 patients who were paced for >10 years, only three (10%) developed echocardiographic evidence of LV dysfunction. Right ventricular apex pacing and prolonged QRS duration were found to be predictive of decreased long‐term LV systolic function (P < 0.05).
Conclusions: Left ventricular dysfunction in patients with congenital complete atrioventricular block is a rare finding, even in those who have been paced for more than 10 years. Right ventricular apex pacing and prolonged QRS duration may be associated with decreased ventricular function over time. At this time, with such a low incidence of cardiac dysfunction, right ventricular pacing should be considered an acceptable first‐line therapy in this population.</description><identifier>ISSN: 1045-3873</identifier><identifier>EISSN: 1540-8167</identifier><identifier>DOI: 10.1111/j.1540-8167.2006.00741.x</identifier><identifier>PMID: 17394451</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Adolescent ; Adult ; Age Factors ; atrioventricular block ; cardiac function ; Cardiac Pacing, Artificial - statistics & numerical data ; Cardiomyopathies - diagnostic imaging ; Cardiomyopathies - epidemiology ; cardiomyopathy ; Child ; Child, Preschool ; Cohort Studies ; Exercise Test ; Female ; Follow-Up Studies ; Heart Block - congenital ; Heart Block - epidemiology ; Heart Block - physiopathology ; Heart Block - therapy ; Heart Ventricles ; Humans ; Infant ; Infant, Newborn ; Male ; pacing ; pediatrics ; Regression Analysis ; Risk Factors ; Survival Analysis ; Texas - epidemiology ; Time ; Ultrasonography ; Ventricular Function</subject><ispartof>Journal of cardiovascular electrophysiology, 2007-04, Vol.18 (4), p.373-377</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4041-dc9570c0c3db9a5ccbaf97a46f235f2cc46bbdb459ab4aa515ee1787b62438a43</citedby><cites>FETCH-LOGICAL-c4041-dc9570c0c3db9a5ccbaf97a46f235f2cc46bbdb459ab4aa515ee1787b62438a43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1540-8167.2006.00741.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1540-8167.2006.00741.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17394451$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KIM, JEFFREY J.</creatorcontrib><creatorcontrib>FRIEDMAN, RICHARD A.</creatorcontrib><creatorcontrib>EIDEM, BENJAMIN W.</creatorcontrib><creatorcontrib>CANNON, BRYAN C.</creatorcontrib><creatorcontrib>ARORA, GAURAV</creatorcontrib><creatorcontrib>SMITH, E. O'BRIAN</creatorcontrib><creatorcontrib>FENRICH, ARNOLD L.</creatorcontrib><creatorcontrib>KERTESZ, NAOMI J.</creatorcontrib><title>Ventricular Function and Long-Term Pacing in Children with Congenital Complete Atrioventricular Block</title><title>Journal of cardiovascular electrophysiology</title><addtitle>J Cardiovasc Electrophysiol</addtitle><description>Objective: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block.
Background: Pacing is a well‐accepted therapy for patients with congenital complete atrioventricular block. The long‐term sequela of right ventricular pacing in this population has not been well described.
Methods: We performed a cohort study on all patients with congenital complete atrioventricular block who underwent pacemaker implantation at our institution from 1972 to 2004. Patients with associated congenital heart disease or ventricular dysfunction prior to pacemaker implantation were excluded.
Results: A total of 63 patients were included in the study. The median age at pacemaker implantation was 6.5 years, with an average follow‐up of 9.9 years. The cumulative dysfunction free survival at 20 years was 92%. In total, four patients (6%) were noted to develop LV dysfunction an average of 15.1 years after pacemaker implantation. Of 30 patients who were paced for >10 years, only three (10%) developed echocardiographic evidence of LV dysfunction. Right ventricular apex pacing and prolonged QRS duration were found to be predictive of decreased long‐term LV systolic function (P < 0.05).
Conclusions: Left ventricular dysfunction in patients with congenital complete atrioventricular block is a rare finding, even in those who have been paced for more than 10 years. Right ventricular apex pacing and prolonged QRS duration may be associated with decreased ventricular function over time. At this time, with such a low incidence of cardiac dysfunction, right ventricular pacing should be considered an acceptable first‐line therapy in this population.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>atrioventricular block</subject><subject>cardiac function</subject><subject>Cardiac Pacing, Artificial - statistics & numerical data</subject><subject>Cardiomyopathies - diagnostic imaging</subject><subject>Cardiomyopathies - epidemiology</subject><subject>cardiomyopathy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Block - congenital</subject><subject>Heart Block - epidemiology</subject><subject>Heart Block - physiopathology</subject><subject>Heart Block - therapy</subject><subject>Heart Ventricles</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>pacing</subject><subject>pediatrics</subject><subject>Regression Analysis</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><subject>Texas - epidemiology</subject><subject>Time</subject><subject>Ultrasonography</subject><subject>Ventricular Function</subject><issn>1045-3873</issn><issn>1540-8167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtO3DAARa2qqLz6C5VX7JLa8SuR2NAAA2hEKwSt1I3lOA54cJzBTsrw93iYEe2y3vhKvudaOgBAjHKcztdFjhlFWYm5yAuEeI6QoDhffQB77w8fU0aUZaQUZBfsx7hACBOO2CewiwWpKGV4D5ifxo_B6smpAM8nr0c7eKh8C-eDv89uTejhD6Wtv4fWw_rBujYYD5_t-ADr1DDejsql2C-dGQ08SWPDn382v7lBPx6CnU65aD5v7wNwd352W19k8--zy_pknmmKKM5aXTGBNNKkbSrFtG5UVwlFeVcQ1hVaU940bUNZpRqqFMPMGCxK0fCCklJRcgCONrvLMDxNJo6yt1Eb55Q3wxSlQKQoOK9SsdwUdRhiDKaTy2B7FV4kRnKtWC7k2qRcm5RrxfJNsVwl9Mv2j6npTfsX3DpNheNN4dk68_Lfw_KqPksh4dkGt3E0q3dchUfJBRFM_rqeyer0ppwJcSN_k1dT15qJ</recordid><startdate>200704</startdate><enddate>200704</enddate><creator>KIM, JEFFREY J.</creator><creator>FRIEDMAN, RICHARD A.</creator><creator>EIDEM, BENJAMIN W.</creator><creator>CANNON, BRYAN C.</creator><creator>ARORA, GAURAV</creator><creator>SMITH, E. O'BRIAN</creator><creator>FENRICH, ARNOLD L.</creator><creator>KERTESZ, NAOMI J.</creator><general>Blackwell Publishing Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200704</creationdate><title>Ventricular Function and Long-Term Pacing in Children with Congenital Complete Atrioventricular Block</title><author>KIM, JEFFREY J. ; FRIEDMAN, RICHARD A. ; EIDEM, BENJAMIN W. ; CANNON, BRYAN C. ; ARORA, GAURAV ; SMITH, E. O'BRIAN ; FENRICH, ARNOLD L. ; KERTESZ, NAOMI J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4041-dc9570c0c3db9a5ccbaf97a46f235f2cc46bbdb459ab4aa515ee1787b62438a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>atrioventricular block</topic><topic>cardiac function</topic><topic>Cardiac Pacing, Artificial - statistics & numerical data</topic><topic>Cardiomyopathies - diagnostic imaging</topic><topic>Cardiomyopathies - epidemiology</topic><topic>cardiomyopathy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Block - congenital</topic><topic>Heart Block - epidemiology</topic><topic>Heart Block - physiopathology</topic><topic>Heart Block - therapy</topic><topic>Heart Ventricles</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>pacing</topic><topic>pediatrics</topic><topic>Regression Analysis</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><topic>Texas - epidemiology</topic><topic>Time</topic><topic>Ultrasonography</topic><topic>Ventricular Function</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KIM, JEFFREY J.</creatorcontrib><creatorcontrib>FRIEDMAN, RICHARD A.</creatorcontrib><creatorcontrib>EIDEM, BENJAMIN W.</creatorcontrib><creatorcontrib>CANNON, BRYAN C.</creatorcontrib><creatorcontrib>ARORA, GAURAV</creatorcontrib><creatorcontrib>SMITH, E. O'BRIAN</creatorcontrib><creatorcontrib>FENRICH, ARNOLD L.</creatorcontrib><creatorcontrib>KERTESZ, NAOMI J.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KIM, JEFFREY J.</au><au>FRIEDMAN, RICHARD A.</au><au>EIDEM, BENJAMIN W.</au><au>CANNON, BRYAN C.</au><au>ARORA, GAURAV</au><au>SMITH, E. O'BRIAN</au><au>FENRICH, ARNOLD L.</au><au>KERTESZ, NAOMI J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ventricular Function and Long-Term Pacing in Children with Congenital Complete Atrioventricular Block</atitle><jtitle>Journal of cardiovascular electrophysiology</jtitle><addtitle>J Cardiovasc Electrophysiol</addtitle><date>2007-04</date><risdate>2007</risdate><volume>18</volume><issue>4</issue><spage>373</spage><epage>377</epage><pages>373-377</pages><issn>1045-3873</issn><eissn>1540-8167</eissn><abstract>Objective: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block.
Background: Pacing is a well‐accepted therapy for patients with congenital complete atrioventricular block. The long‐term sequela of right ventricular pacing in this population has not been well described.
Methods: We performed a cohort study on all patients with congenital complete atrioventricular block who underwent pacemaker implantation at our institution from 1972 to 2004. Patients with associated congenital heart disease or ventricular dysfunction prior to pacemaker implantation were excluded.
Results: A total of 63 patients were included in the study. The median age at pacemaker implantation was 6.5 years, with an average follow‐up of 9.9 years. The cumulative dysfunction free survival at 20 years was 92%. In total, four patients (6%) were noted to develop LV dysfunction an average of 15.1 years after pacemaker implantation. Of 30 patients who were paced for >10 years, only three (10%) developed echocardiographic evidence of LV dysfunction. Right ventricular apex pacing and prolonged QRS duration were found to be predictive of decreased long‐term LV systolic function (P < 0.05).
Conclusions: Left ventricular dysfunction in patients with congenital complete atrioventricular block is a rare finding, even in those who have been paced for more than 10 years. Right ventricular apex pacing and prolonged QRS duration may be associated with decreased ventricular function over time. At this time, with such a low incidence of cardiac dysfunction, right ventricular pacing should be considered an acceptable first‐line therapy in this population.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>17394451</pmid><doi>10.1111/j.1540-8167.2006.00741.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Adolescent Adult Age Factors atrioventricular block cardiac function Cardiac Pacing, Artificial - statistics & numerical data Cardiomyopathies - diagnostic imaging Cardiomyopathies - epidemiology cardiomyopathy Child Child, Preschool Cohort Studies Exercise Test Female Follow-Up Studies Heart Block - congenital Heart Block - epidemiology Heart Block - physiopathology Heart Block - therapy Heart Ventricles Humans Infant Infant, Newborn Male pacing pediatrics Regression Analysis Risk Factors Survival Analysis Texas - epidemiology Time Ultrasonography Ventricular Function |
| title | Ventricular Function and Long-Term Pacing in Children with Congenital Complete Atrioventricular Block |
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