Predictors of left ventricular remodelling and failure in right ventricular pacing in the young
Aims To identify risk factors for left ventricular (LV) dysfunction in right ventricular (RV) pacing in the young. Methods and results Left ventricular function was evaluated in 82 paediatric patients with either non-surgical (n = 41) or surgical (n= 41) complete atrioventricular block who have been...
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| Veröffentlicht in: | European heart journal 2009-05, Vol.30 (9), p.1097-1104 |
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| creator | Gebauer, Roman A. Tomek, Viktor Salameh, Aida Marek, Jan Chaloupecký, Václav Gebauer, Roman Matějka, Tomáš Vojtovič, Pavel Janoušek, Jan |
| description | Aims To identify risk factors for left ventricular (LV) dysfunction in right ventricular (RV) pacing in the young. Methods and results Left ventricular function was evaluated in 82 paediatric patients with either non-surgical (n = 41) or surgical (n= 41) complete atrioventricular block who have been 100% RV paced for a mean period of 7.4 years. Left ventricular shortening fraction (SF) decreased from a median (range) of 39 (24–62)% prior to implantation to 32 (8–49)% at last follow-up (P < 0.05). Prevalence of a combination of LV dilatation (LV end-diastolic diameter >+2z-values) and dysfunction (SF < 0.26) was found to increase from 1.3% prior to pacemaker implantation to 13.4% (11/82 patients) at last follow-up (P = 0.01). Ten of these 11 patients had progressive LV remodelling and 8 of 11 were symptomatic. The only significant risk factor for the development of LV dilatation and dysfunction was the presence of epicardial RV free wall pacing (OR = 14.3, P < 0.001). Other pre-implantation demographic, diagnostic, and haemodynamic factors including block aetiology, pacing variables, and pacing duration did not show independent significance. Conclusion Right ventricular pacing leads to pathologic LV remodelling in a significant proportion of paediatric patients. The major independent risk factor is the presence of epicardial RV free wall pacing, which should be avoided whenever possible. |
| doi_str_mv | 10.1093/eurheartj/ehp060 |
| format | Article |
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Methods and results Left ventricular function was evaluated in 82 paediatric patients with either non-surgical (n = 41) or surgical (n= 41) complete atrioventricular block who have been 100% RV paced for a mean period of 7.4 years. Left ventricular shortening fraction (SF) decreased from a median (range) of 39 (24–62)% prior to implantation to 32 (8–49)% at last follow-up (P < 0.05). Prevalence of a combination of LV dilatation (LV end-diastolic diameter >+2z-values) and dysfunction (SF < 0.26) was found to increase from 1.3% prior to pacemaker implantation to 13.4% (11/82 patients) at last follow-up (P = 0.01). Ten of these 11 patients had progressive LV remodelling and 8 of 11 were symptomatic. The only significant risk factor for the development of LV dilatation and dysfunction was the presence of epicardial RV free wall pacing (OR = 14.3, P < 0.001). Other pre-implantation demographic, diagnostic, and haemodynamic factors including block aetiology, pacing variables, and pacing duration did not show independent significance. Conclusion Right ventricular pacing leads to pathologic LV remodelling in a significant proportion of paediatric patients. The major independent risk factor is the presence of epicardial RV free wall pacing, which should be avoided whenever possible.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehp060</identifier><identifier>PMID: 19286675</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adolescent ; Biological and medical sciences ; Cardiac dysrhythmias ; Cardiac Pacing, Artificial - adverse effects ; Cardiac Pacing, Artificial - methods ; Cardiac resynchronization therapy ; Cardiology. Vascular system ; Child ; Child, Preschool ; Children ; Clinical Research ; Congenital heart disease ; Diastole - physiology ; Female ; Heart ; Heart Block - surgery ; Heart failure ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Infant ; Infant, Newborn ; Male ; Medical sciences ; Permanent cardiac pacing ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Risk Assessment ; Treatment Outcome ; Ventricular Dysfunction, Left - etiology ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Dysfunction, Left - surgery ; Ventricular Remodeling - physiology ; Young Adult</subject><ispartof>European heart journal, 2009-05, Vol.30 (9), p.1097-1104</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org 2009</rights><rights>2009 INIST-CNRS</rights><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-945be30178069075d6555377e57e479eebe13b289fc11673770ec2277da2aa813</citedby><cites>FETCH-LOGICAL-c525t-945be30178069075d6555377e57e479eebe13b289fc11673770ec2277da2aa813</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21416460$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19286675$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gebauer, Roman A.</creatorcontrib><creatorcontrib>Tomek, Viktor</creatorcontrib><creatorcontrib>Salameh, Aida</creatorcontrib><creatorcontrib>Marek, Jan</creatorcontrib><creatorcontrib>Chaloupecký, Václav</creatorcontrib><creatorcontrib>Gebauer, Roman</creatorcontrib><creatorcontrib>Matějka, Tomáš</creatorcontrib><creatorcontrib>Vojtovič, Pavel</creatorcontrib><creatorcontrib>Janoušek, Jan</creatorcontrib><title>Predictors of left ventricular remodelling and failure in right ventricular pacing in the young</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Aims To identify risk factors for left ventricular (LV) dysfunction in right ventricular (RV) pacing in the young. Methods and results Left ventricular function was evaluated in 82 paediatric patients with either non-surgical (n = 41) or surgical (n= 41) complete atrioventricular block who have been 100% RV paced for a mean period of 7.4 years. Left ventricular shortening fraction (SF) decreased from a median (range) of 39 (24–62)% prior to implantation to 32 (8–49)% at last follow-up (P < 0.05). Prevalence of a combination of LV dilatation (LV end-diastolic diameter >+2z-values) and dysfunction (SF < 0.26) was found to increase from 1.3% prior to pacemaker implantation to 13.4% (11/82 patients) at last follow-up (P = 0.01). Ten of these 11 patients had progressive LV remodelling and 8 of 11 were symptomatic. The only significant risk factor for the development of LV dilatation and dysfunction was the presence of epicardial RV free wall pacing (OR = 14.3, P < 0.001). Other pre-implantation demographic, diagnostic, and haemodynamic factors including block aetiology, pacing variables, and pacing duration did not show independent significance. Conclusion Right ventricular pacing leads to pathologic LV remodelling in a significant proportion of paediatric patients. The major independent risk factor is the presence of epicardial RV free wall pacing, which should be avoided whenever possible.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiac Pacing, Artificial - adverse effects</subject><subject>Cardiac Pacing, Artificial - methods</subject><subject>Cardiac resynchronization therapy</subject><subject>Cardiology. Vascular system</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Clinical Research</subject><subject>Congenital heart disease</subject><subject>Diastole - physiology</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Block - surgery</subject><subject>Heart failure</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Permanent cardiac pacing</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Risk Assessment</subject><subject>Treatment Outcome</subject><subject>Ventricular Dysfunction, Left - etiology</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Dysfunction, Left - surgery</subject><subject>Ventricular Remodeling - physiology</subject><subject>Young Adult</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUFv1DAQhS0EokvhzglZSOWCQm0ntuNLJVSVtqgCDoCqXiyvM9l4ycbBjiv67_E2q4Vy4uTD--Z53jyEXlLyjhJVHkMKHZgwrY-hG4kgj9CCcsYKJSr-GC0IVbwQor4-QM9iXBNCakHFU3RAFauFkHyB9JcAjbOTDxH7FvfQTvgWhik4m3oTcICNb6Dv3bDCZmhwa1yfAmA34OBW3UN4NHbLZW3qAN_5NKyeoyet6SO82L2H6NuHs6-nF8XV5_PL0_dXheWMT4Wq-BJKQmVNhCKSN4JzXkoJXEIlFcASaLlktWotpUJmhYBlTMrGMGNqWh6ik9l3TMsNNHa7len1GNzGhDvtjdMPlcF1euVvNctnkIRlgzc7g-B_JoiT3rhoc3IzgE9RC8kIZ6XK4Ot_wLVPYcjhNKOck7pSMkNkhmzwMQZo95tQorfV6X11eq4uj7z6O8GfgV1XGTjaASZa07fBDNbFPcdoRUV1b_R25nwa_-fbYqZdnODXnjfhh97emeuL6xtNP35i9Pzmuy7L3xoExJ8</recordid><startdate>20090501</startdate><enddate>20090501</enddate><creator>Gebauer, Roman A.</creator><creator>Tomek, Viktor</creator><creator>Salameh, Aida</creator><creator>Marek, Jan</creator><creator>Chaloupecký, Václav</creator><creator>Gebauer, Roman</creator><creator>Matějka, Tomáš</creator><creator>Vojtovič, Pavel</creator><creator>Janoušek, Jan</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</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>7QP</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20090501</creationdate><title>Predictors of left ventricular remodelling and failure in right ventricular pacing in the young</title><author>Gebauer, Roman A. ; Tomek, Viktor ; Salameh, Aida ; Marek, Jan ; Chaloupecký, Václav ; Gebauer, Roman ; Matějka, Tomáš ; Vojtovič, Pavel ; Janoušek, Jan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-945be30178069075d6555377e57e479eebe13b289fc11673770ec2277da2aa813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiac Pacing, Artificial - adverse effects</topic><topic>Cardiac Pacing, Artificial - methods</topic><topic>Cardiac resynchronization therapy</topic><topic>Cardiology. Vascular system</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Clinical Research</topic><topic>Congenital heart disease</topic><topic>Diastole - physiology</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Block - surgery</topic><topic>Heart failure</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Permanent cardiac pacing</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Risk Assessment</topic><topic>Treatment Outcome</topic><topic>Ventricular Dysfunction, Left - etiology</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>Ventricular Dysfunction, Left - surgery</topic><topic>Ventricular Remodeling - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gebauer, Roman A.</creatorcontrib><creatorcontrib>Tomek, Viktor</creatorcontrib><creatorcontrib>Salameh, Aida</creatorcontrib><creatorcontrib>Marek, Jan</creatorcontrib><creatorcontrib>Chaloupecký, Václav</creatorcontrib><creatorcontrib>Gebauer, Roman</creatorcontrib><creatorcontrib>Matějka, Tomáš</creatorcontrib><creatorcontrib>Vojtovič, Pavel</creatorcontrib><creatorcontrib>Janoušek, Jan</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gebauer, Roman A.</au><au>Tomek, Viktor</au><au>Salameh, Aida</au><au>Marek, Jan</au><au>Chaloupecký, Václav</au><au>Gebauer, Roman</au><au>Matějka, Tomáš</au><au>Vojtovič, Pavel</au><au>Janoušek, Jan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of left ventricular remodelling and failure in right ventricular pacing in the young</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>30</volume><issue>9</issue><spage>1097</spage><epage>1104</epage><pages>1097-1104</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Aims To identify risk factors for left ventricular (LV) dysfunction in right ventricular (RV) pacing in the young. Methods and results Left ventricular function was evaluated in 82 paediatric patients with either non-surgical (n = 41) or surgical (n= 41) complete atrioventricular block who have been 100% RV paced for a mean period of 7.4 years. Left ventricular shortening fraction (SF) decreased from a median (range) of 39 (24–62)% prior to implantation to 32 (8–49)% at last follow-up (P < 0.05). Prevalence of a combination of LV dilatation (LV end-diastolic diameter >+2z-values) and dysfunction (SF < 0.26) was found to increase from 1.3% prior to pacemaker implantation to 13.4% (11/82 patients) at last follow-up (P = 0.01). Ten of these 11 patients had progressive LV remodelling and 8 of 11 were symptomatic. The only significant risk factor for the development of LV dilatation and dysfunction was the presence of epicardial RV free wall pacing (OR = 14.3, P < 0.001). Other pre-implantation demographic, diagnostic, and haemodynamic factors including block aetiology, pacing variables, and pacing duration did not show independent significance. Conclusion Right ventricular pacing leads to pathologic LV remodelling in a significant proportion of paediatric patients. The major independent risk factor is the presence of epicardial RV free wall pacing, which should be avoided whenever possible.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>19286675</pmid><doi>10.1093/eurheartj/ehp060</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adolescent Biological and medical sciences Cardiac dysrhythmias Cardiac Pacing, Artificial - adverse effects Cardiac Pacing, Artificial - methods Cardiac resynchronization therapy Cardiology. Vascular system Child Child, Preschool Children Clinical Research Congenital heart disease Diastole - physiology Female Heart Heart Block - surgery Heart failure Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Infant Infant, Newborn Male Medical sciences Permanent cardiac pacing Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Risk Assessment Treatment Outcome Ventricular Dysfunction, Left - etiology Ventricular Dysfunction, Left - physiopathology Ventricular Dysfunction, Left - surgery Ventricular Remodeling - physiology Young Adult |
| title | Predictors of left ventricular remodelling and failure in right ventricular pacing in the young |
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