AI Article Synopsis
- Pacing-induced cardiomyopathy (PICM) is a major cause of heart failure, particularly in patients reliant on right ventricular pacing, and upgrading to cardiac resynchronization therapy (CRT) may help.
- A study analyzed 43 patients who upgraded to CRT over 10 years, finding significant improvements in heart function, with average left ventricular ejection fraction (LVEF) rising from 28.7% to 44.3%.
- The research also indicated that certain medications like ACE inhibitors or ARBs contribute to LVEF improvement, and while complications were low, a small percentage of upgrades required additional procedures.
Article Abstract
Background: Pacing-induced cardiomyopathy (PICM) is an important cause of heart failure in patients with a right ventricular pacing burden. Recent evidence suggests that an upgrade to cardiac resynchronization therapy (CRT) may confer benefit in PICM.
Objective: To assess the extent and identify predictors of improvement following upgrade to CRT in patients with PICM.
Methods: We retrospectively analyzed 43 patients undergoing CRT upgrade for PICM over the 10-year period of 2011 to 2021 at our center. All patients with PICM who underwent device upgrade from a dual- or single-chamber ventricular pacemaker to CRT were included. PICM was defined as a decrease of ≥10% in left ventricular ejection fraction (LVEF), resulting in an LVEF <50% among patients with ≥20% Right ventricular pacing burden without an alternative cause for cardiomyopathy.
Results: LVEF significantly improved from 28.7% preupgrade to 44.3% post-CRT upgrade ( .01). Of 37 patients with severe LV dysfunction, 34 (91.9%) improved to an LVEF >35% and 13 (35.1%) improved to an LVEF >50%. The LV end-diastolic diameter decreased from 5.9 cm preupgrade to 5.4 cm postupgrade ( .01). Using linear regression, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use was associated with significant LVEF improvement (+7.21%, .05). We observed a low rate of complications, and 1 in 4 CRT upgrades required venoplasty (n = 10 of 43, 23.3%).
Conclusion: We provide further evidence for the benefit of CRT upgrade in the management of patients with PICM.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134389 | PMC |
| http://dx.doi.org/10.1016/j.hroo.2023.01.004 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!