Evolution of left ventricular function in pediatric patients with permanent right ventricular pacing with and without structural heart disease

Abstract

Background Chronic right ventricular (RV) pacing may have detrimental effect on left ventricular (LV) function and may promote to heart failure in adults. The effect of chronic RV pacing on left ventricular performance is not well studied in a pediatric population. Aim The aim of this retrospective study was to assess the evolution of LV function in a pediatric pacemaker population with and without structural heart disease (HD). Methods and Results 98 pediatric patients (59 males) were studied retrospectively. 42 patients had pacemaker indication without structural heart disease. 25 out of the remaining 56 patients had isolated and the others complex congenital malformation. Patients were distributed in six age groups (group I: <1 yr, group II: 1-2 yrs, group III: 3-4 yrs, group IV: 5-7 yrs, group V: 8-11 yrs, group 6: 12-15 yrs) and were followed up for an average of 58.69±45.23 months (ranging: 3-188.5 months) with ECG and transthoracic echocardiography. LV fractional shortening (FS) was used as a marker of LV function. LV FS did not change statistically in the age groups (group I: 0.43± 0.09, group 6: 0.39±0.08 ;p=NS). When the progression of LV FS was assessed in the subgroups according to the presence or absence of structural HD, there could be only tendencies observed (isolated: group I: 0.51±0.06, group 6 0.31±0.09, p=NS; complex: group I: 0.42±0.06, group 5: 0.33±0.06, p=NS). Conclusion Chronic RV pacing in pediatric patients with and without structural HD does not necessarily results in decline of LV function.