Abstract

Objective This study aimed to investigate the impact of different right ventricular pacing sites on cardiac remodeling in a long term follow-up. Methods One hundred and thirty-eight consecutive patients with dual chamber pacemaker implantation were enrolled from January 2008 to December 2008 in The First Affiliated Hospital of Dalian Medical University. Electrocardiogram and echocardiography were performed before operation and during follow-up. Results Seventy-two patients with right ventricular septal pacing (RVS) were following up for (43.5±13.8) months, and the other 66 patients with right ventricular apical pacing (RVA) were following up for (45.3±11.3) months. The left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), systolic septal thickness (SST), left ventricular posterior wall systolic thickness (LVPWST), mitral regurgitation (MR) and tricuspid regurgitation (TR) were similar between the RVS and RVA group (P>0.05), while RVA pacing was associated with larger right ventricular end-diastolic diameter [RVEDD, (19.6±2.5) mm vs. (17.4±2.6) mm, P=0.04] than RVS group when the follow-up ended. MR and TR occurred quite often both in RVA group and RVS group [RVA group MR: 32 cases vs.18 cases, TR: 38 cases vs.20 cases, P=0.01; RVS group MR: 32 cases vs.24 cases, 30 cases vs.22 cases, P=0.01] after implantation. There were no statistical differences in left ventricular ejection fraction (LVEF)、LVEDD、LAD、RVEDD、SST and LVPWST before and after implantation both in RVA and RVS group. The SST [(9.3±1.4) mm vs. (10.6±1.4) mm, P=0.01] and LVPWST [(9.2±1.1) mm vs. (10.2±1.3) mm, P=0.02] in middle-RVS pacing patients were thinner than those in the non-middle-RVS pacing patients. In middle-RVS pacing patients, the LAD (P=0.03) was thinner than that befere implantation and there were no statistical differences in MR (P=0.77) and TR (P=0.06) before. Conclusion The effect of middle-RVS pacing in preventing cardiac remodeling and valve regurgitation are more obvious. LVEF does not decrease in the right ventricular apical pacing patients with normal left ventricular function before pacemaker implantation. Key words: Cardiac pacing; Cardiac remodeling; Lead position

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.