Assessment of Biventricular Function by Echocardiography in Patients with Right Ventricular Apical Pacing

Abstract

Introduction: Artificial cardiac pacing is a consolidated, safe, and effective treatment strategy that has been evolving for 60 years. In a normal heart, the left ventricle (LV) contracts in a fast and synchronized manner. Stimulation anywhere in the right ventricle (RV) alters the natural pattern of activation and as a consequence the ventricular contraction. This may lead to the induction of asynchrony with potential risk for the development of ventricular dysfunction. The majority of studies have looked into left ventricular dysfunction, while effects on the RV have not been studied. Furthermore, there are little data on the chronology of events that occur in pacemaker patients. We, therefore, aimed to evaluate diastolic and systolic functions of LV and RV in consecutive patients undergoing Ventricle is paced, sensed, and the pulse generator inhibits pacing output in response to a sensed ventricular event (VVI) permanent pacemaker implantation over 6 months using trans-thoracic echocardiography. Materials and Methods: This was a hospital-based observational study from October 2017 to April 2019. Conclusion: Diastolic abnormalities are first to appear which are followed by appearance of systolic abnormalities of the respective ventricles. The right ventricular dysfunction (tricuspid annular plane systolic excursion <17 mm) developed in 28% at 1 month and in 62% at the end of 6 months. The left ventricular dysfunction (ejection fraction< 50%) occurs later, LV dysfunction developed in 14%, and worsening of LV function developed in 16% of the study population at the end of study, that is, 6 months.