ASSESSMENT OF RIGHT VENTRICULAR FUNCTION FOLLOWING PERMANENT PACEMAKER IMPLANTATION BY ECHOCARDIOGRAPHY (INCLUDING 3D ECHOCARDIOGRAPHY)

Abstract

Objective: Several studies have shown that unfavorable ventricular remodelling & mechanical dyssynchrony caused by Right ventricular (RV) pacing leading to development of Left Ventricular dysfunction. Nevertheless, impact of RV pacing on Right Ventricle function has not been thoroughly assessed. Hence, prospective study was done to assess RV dimensions & function by 2D and three-dimensional (3D) echocardiography at 3 months & 6 months after pacemaker implantation Design and method: This study was a prospective single-centre study. All patients who underwent pacemaker implantation were assessed for RV function by 2D and 3D Echocardiography at baseline (pre-procedure), 3 months & 6 months after pacemaker implantation. The change in follow-up period was evaluated by using single factor analysis of variance ANOVA with repeated measures in normally distributed data & Bonferroni post-hoc test. A p value of <0.05 is considered to be statistically significant Results: From January 2022 to December 2022, a total of 66 patients with permanent pacemaker were enrolled in the study. There was statistically non-significant changes in mean LVEF (%) during follow up (62.13±3.92(Baseline) vs. 62.21±4.15(3-month) vs 62.03+3.83 (6-months), p value>0.05).However, there was statistically significant changes in mean PASP (mm Hg) during follow up (18.45±3.45 (Baseline) vs. 22.18±3.76 (3-month) vs 26.45+3.97, p value <0.05). Also, there was statistically significant changes in mean RIMP during follow up (0.48±0.04(Baseline) vs. 0.50±0.04(3-month) vs 0.50+0.03(6-month),p value<0.05).Likewise, there was statistically significant changes in mean RV E/E’ during follow up (4.47±0.57(Baseline) vs. 4.70±0.74(3-month) vs 4.95+0.82(6-month),p value <0.05).In addition, there was statistically significant changes in mean TR Jet Area (cm2) during follow up (1.68±0.26(Baseline) vs. 2.22±0.43(3-month) vs 2.56+0.53(6-month), p value <0.05). But, there was statistically non-significant changes in mean RVEF % (3D Echo) during follow up (53.51± 2.75(Baseline) vs. 53.02±2.64 (3-month) vs 53.48+2.34 (6-month), p value >0.05).Other echocardiographic parameters of RV function did not show any change in 3-months & 6-months follow-up. Conclusions: There is change in Right Ventricular function after Pacemaker implantation which can be documented as early as 6 months post implantation. Permanent pacemaker was associated with changes in RIMP, RV E/E’, PASP, TR JET AREA during 6 months after Right ventricular pacing