Adverse Effects of Long-Term Right Ventricular Apical Pacing and Identification of Patients at Risk of Atrial Fibrillation and Heart Failure

2012 ◽  
Vol 35 (8) ◽  
pp. 1035-1043 ◽  
Author(s):  
ANTONIO DE SISTI ◽  
MANLIO F. MÁRQUEZ ◽  
JOELCI TONET ◽  
AIM BONNY ◽  
ROBERT FRANK ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
At Risk ◽  
Adverse Effects ◽  
Right Ventricular ◽  
Patients At Risk ◽  
Right Ventricular Apical Pacing

Pacemaker Induced Cardiomyopathy: An Overview of Current Literature

2021 ◽  
Vol 17 ◽  
Author(s):  
Callan Gavaghan
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Right Ventricular ◽  
Current Literature ◽  
Left Ventricular ◽  
Lv Function ◽  
Patients At Risk ◽  
Rv Pacing ◽  
Clinical Heart Failure ◽  
Potential Methods

: Pacemaker induced cardiomyopathy (PICM) is commonly defined as a reduction in left ventricular (LV) function in the setting of right ventricular (RV) pacing. This condition may be associated with the onset of clinical heart failure in those affected. Recent studies have focused on potential methods of identifying patients at risk of this condition, in addition to hypothesizing the most efficacious ways to manage these patients. Newer pacing options, such as His bundle pacing, may avoid the onset of PICM entirely.

P4377Use of LV Deformation Imaging to predict long term Heart Failure Risk in high risk patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Haji ◽  
T Marwick ◽  
C Neil ◽  
S Stewart ◽  
M Carrington ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Multivariable Analysis ◽  
P Value ◽  
Ageing Population ◽  
Patients At Risk

Abstract Background The increasing prevalence of heart failure (HF), due to hypertension, ischaemic heart disease, diabetes, obesity, and ageing population demands identification of at-risk subgroup whom we could target on prevention strategies. In a same cohort of patients at risk of HF (70% with CAD), 13% developed new HF hospitalization or death over 4.3 years of follow-up, however, disease management program did not confer any benefit to outcome and LV ejection fraction (EF) was not predictive of progression to HF. Better risk stratification strategies are needed. In this study, we sought whether advanced echo measure on deformation, global longitudinal strain (GLS) would predict HF admission over a long term follow up and thereby define an at-risk group. Aim: To determine which of the LV morphology, function and deformation parameters, best predict new HF admission or HF death in pts at risk but without prior dx of HF. Method Echocardiograms (including measurement of LV, size, function, morphology and deformation) were obtained in 431 inpatients (mean age 65±11, 72% male) at risk of HF. LV global longitudinal strain (GLS) and strain rate (GLSR) were measured offline (EchoPac, GE). Long term (9 years) follow up data were obtained via data linkage. Results 63 pts (15%) reached the end-point of HF admission or HF death. LV deformation showed a univariable association with outcome (Table). In multivariable analysis, including known significant predictors of outcome (age, sex, BMI, diabetes, hypertension), GLS less than 18 remained an independent predictor (Table), in addition to age and DM at baseline. EF and LV mass were not predictors of heart failure. HR (95% CI) P value HR (95% CI) P value HR (95% CI) P value Age 1.1 (1–1.1) <0.01 1.1 (1–1.1) 0.04 1 (1–1.1) 0.04 Sex 1.0 (0.6–1.7) 0.9 0.8 (0.4–1.8) 0.6 0.8 (0.4–1.8) 0.6 BMI 1.0 (1–1.1) 0.05 1 (0.9–1.1) 0.7 1 (0.9–1.1) 0.7 DM 2.6 (1.6–4.3) <0.01 2.7 (1.4–5.3) <0.01 2.7 (1.4–5.2) 0.04 LVMI 1.0 (1.0–1.0) <0.01 1 (0.9–1.0) 0.7 1 (0.99–1.0) 0.7 Impaired EF, % 1.0 (0.9–1.0) <0.01 1 (0.9–1.0) 0.16 0.97 (0.94–1.0) 0.04 Diastolic dysfunction 2.3 (1.4–3.7) <0.01 0.8 (0.3–1.7) 0.5 0.7 (0.3–1.7) 0.5 GLS 1.3 (1.4–1.2) <0.01 1.1 (1–1.2) 0.07 GLS <18 5.3 (2.8–10.2) <0.01 2.3 (1.1–5.1) 0.04 Conclusion GLS <18 is independently associated with increasing new onset heart failure admission and HF mortality in patients at risk of HF.

P743 Right ventricular function is important for exercise capacity in patients at risk of heart failure

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Kikuchi ◽  
S Kitada ◽  
K Wakami ◽  
T Goto ◽  
T Sugiura ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Heart Disease ◽  
Right Ventricular ◽  
Flow Velocity ◽  
Exercise Capacity ◽  
Exercise Testing ◽  
Transmitral Flow ◽  
Patients At Risk ◽  
Rv Function

Abstract Background and Purpose It is important to evaluate exercise capacity to detect the development of heart failure (HF) in patients with heart disease. The pathology of exercise capacity is multi-factorial, and cardiac function is recognized as one of the most important determinants. However, the correlation between right ventricular (RV) function and exercise capacity is not fully understood in the subjects without HF. Therefore, we assessed the relationship between RV function and exercise capacity, both in patients with HF (HF+) and in patients with heart disease but not developed HF (HF-). Methods Two hundred and fifty-two patients with heart disease who underwent both Doppler echocardiography at rest and cardio-pulmonary exercise testing (CPET) for the assessment of heart function were enrolled (HF+: n = 142, HF-: n = 110). We measured left ventricular ejection fraction (LVEF), peak early diastolic transmitral flow velocity (E), peak late diastolic transmitral flow velocity (A), early diastolic mitral annular velocity (e’), left atrial volume (LAV), and tricuspid annular plane systolic excursion (TAPSE) by echocardiography. After echocardiographic examination, symptom-limited exercise testing was performed with simultaneous respiratory gas analysis, and peak oxygen consumption (pVO2) was determined. Blood examination including hemoglobin (Hb) and brain natriuretic peptide (BNP) was done on the same day. Results There were significant relationships between pVO2 and LVEF (r = 0.16, p = 0.005), e" (r = 0.51, p &lt; 0.0001), E/e" (r=-0.47, p &lt; 0.0001), LAV (r=-0.21, p = 0.0002), and TAPSE (r = 0.33, p &lt; 0.0001) in the whole subjects. In the multiple regression analyses, age, Hb, E/e" and TAPSE were selected as significant determinants for pVO2 both in HF+ (R²=0.39, p &lt; 0.0001) and HF- (R²=0.33, p &lt; 0.0001). Conclusion RV function is the prime determinant of exercise capacity in patients at risk of HF, as well as in patients with HF. Abstract P743 Figure.

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