Introduction: This systematic review aims to evaluate the incidence and predictors of pacemaker-induced cardiomyopathy (PICM) in patients undergoing right ventricular pacing.
Areas Covered: A literature review was conducted using MeSH terms (Right ventricular pacing, Pacemaker-related cardiomyopathy, Pacemaker-induced cardiomyopathy) in PubMed, EMBASE, Web of science CINAHL, and the Cochrane Library until October 2021. All data reporting the incidence of PICM after implantation of right-sided pacemakers or implantable cardioverter-defibrillator (ICD) were retrieved from the eligible studies.
Expert Opinion: Out of 3,625 articles, 20 studies met the inclusion criteria that included 5,381 patients. . The mean age of the patients ranged between 55.8 ± 13.5 and 77.4 ± 10.8 years. The mean incidence of PICM was 25.7%. Mean ejection fraction (EF) at baseline ranged from 48 ± 1% and 62.1 ± 11.2%, while mean EF at follow-up ranged between 33.7 ± 7.4% and 53.2 ± 8.2%. Three studies reported a decline of >20% EF at follow-up. RV pacing was associated with a considerable risk of PICM, with biological factors, such as male gender, old age, increased QRS duration, and chronic RV pacing burden playing an important role in the development of disease.
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http://dx.doi.org/10.1080/14779072.2022.2062323 | DOI Listing |
Egypt Heart J
January 2025
Department of Cardiology, Hangzhou First People's Hospital, #261 Huansha Road, Hangzhou, 310000, Zhejiang Province, China.
Background: To investigate the optimization of leadless pacemaker placement and to assess its impact on heart synchronization and tricuspid regurgitation.
Results: A clinical trial was conducted involving 53 patients who underwent leadless pacemaker implantation at the Second Affiliated Hospital of Zhejiang University School of Medicine and Hangzhou First People's Hospital between March 2022 and February 2023. Implantation site localization was determined using the 18-segment method under RAO 30° imaging.
Pacing Clin Electrophysiol
January 2025
Servei de Cardiologia, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Introduction: Right ventricular (RV) pacing can impair left ventricular function and cause heart failure, known as pacing-induced cardiomyopathy (PICM). Upgrade to cardiac resynchronization (CRT) is its usual treatment; recently left bundle branch area pacing (LBBAP) has emerged as a potential alternative. Deep septal pacing (DSP), a simplified alternative to LBBAP, is still able to achieve narrower paced QRS than during conventional RV pacing.
View Article and Find Full Text PDFHeart Rhythm
December 2024
Division of Cardiology, Heart Institute, Children's Hospital Colorado, University of Colorado, Aurora, Colorado.
Background: Pacemaker and implantable cardioverter-defibrillator (ICD) lead placement traditionally uses fluoroscopy, often with inaccurate lead placement on the free wall rather than on the ventricular septum, with associated longer QRS duration and pacemaker-induced cardiomyopathy while exposing staff and patients to radiation.
Objective: We sought to determine whether transesophageal 3-dimensional echocardiography (3DE) guidance improves lead placement accuracy in the ventricular septum, results in shorter paced QRS durations, and reduces fluoroscopy exposure.
Methods: In a single-center case-control study, 3DE guided right ventricular or atrial pacemaker and ICD leads to the desired location, with fluoroscopy used per operator preference.
Herzschrittmacherther Elektrophysiol
December 2024
Medizinische Hochschule Hannover, Hannover, Deutschland.
Left bundle branch area pacing is currently the most common form of physiological pacing prior to His bundle pacing. It is intended to prevent or correct the development of pacemaker-induced cardiomyopathy and is being used more and more frequently. In order to be able to perform this successfully, knowledge regarding the specific anatomy and radiological anatomy as well as the ECG criteria for left bundle branch pacing is required in addition to knowledge of the tools.
View Article and Find Full Text PDFHeart Fail Rev
November 2024
First Department of Cardiology, National and Kapodistrian University of Athens, School of Medicine "Hippokration" General Hospital, 114 Vasilissis Sofias avenue, Athens, 11527, Greece.
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