scholarly journals Major determinant of the occurrence of pacing-induced cardiomyopathy in complete atrioventricular block: a multicentre, retrospective analysis over a 15-year period in South Korea

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019048 ◽  
Author(s):  
Jun Hyung Kim ◽  
Ki-Woon Kang ◽  
Jung Yeon Chin ◽  
Tae-Seok Kim ◽  
Jae-Hyeong Park ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
South Korea ◽  
Retrospective Analysis ◽  
Atrioventricular Block ◽  
Left Ventricular ◽  
Major Determinant ◽  
Complete Atrioventricular Block ◽  
Qrs Duration ◽  
Lv Ejection Fraction ◽  
Complete Atrioventricular

ObjectivesThe predictors of pacing-induced cardiomyopathy (PICM) for complete atrioventricular block (CAVB) have not yet been defined. The aim of this study was to investigate the major determinant of the occurrence of PICM.SettingThis is a multicentre, retrospective analysis of CAVB from tertiary referral centres in Daejeon, South Korea.ParticipantsA cohort of 900 consecutive patients with an implanted pacemaker was collected from December 2001 to August 2015. Of these, a total of 130 patients with CAVB with pacing-dependent rhythm who underwent ECG and echocardiogram before and after implantation were analysed for the occurrence of PICM.Outcome measuresCox proportional hazards models evaluated the determinant of PICM by ECG, device parameters and echocardiogram over a mean of 4.5 years.ResultsPICM was observed in 16.1% (n=21) of all patients with CAVB (age, 64±11 years; male, 36.2%). The preimplant left ventricular (LV) ejection fraction (66%±9% vs 66%±8%) and non-apical pacing (40.4% vs 33.3%) were similar; however, the native QRS duration (124±34 ms vs 149±32 ms) and the paced QRS duration (pQRSd) (139±29 ms vs 167±28 ms) were significantly different between the two groups. The postimplant LV ejection fraction (61%±7% vs 31%±8%) was also significantly different at the end of follow-up. A pQRSd significantly correlated with PICM (HR 1.05, 95% CI 1.02 to 1.09, P=0.001). A pQRSd with a cut-off value of above 140 ms had a sensitivity of 95% while a pQRSd with a cut-off value of above 167 ms had a specificity of 90% for PICM.ConclusionIn patients with CAVB with pacing-dependent rhythm, regardless of the pacing site, the pQRSd is a major determinant of the occurrence of PICM.

Abstract 18427: Low Left Ventricular Ejection Fraction and β-blocker Use Before Admission is Associated With In-hospital Cardiac Complications in Patients With Takotsubo Cardiomyopathy

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ken Kato ◽  
Yuichi Saito ◽  
Yoshiaki Sakai ◽  
Iwao Ishibashi ◽  
Masashi Yamamoto ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Odds Ratio ◽  
Multivariate Logistic Regression Analysis ◽  
Left Ventricular ◽  
Cardiac Complications ◽  
Complete Atrioventricular Block ◽  
Multivariate Logistic Regression ◽  
Β Blocker ◽  
Lv Ejection Fraction ◽  
Complete Atrioventricular

Introduction: The prognosis of patients with takotsubo cardiomyopathy (TC) is thought to be relatively favorable. However, serious cardiac complications during hospitalization occur in some patients. There is little information about risk factors associated with in-hospital cardiac complications in patients with TC. Hypothesis: We assessed the hypothesis that severe left ventricular (LV) dysfunction is associated with in-hospital cardiac complications in patients with TC. Methods: A total of 154 consecutive patients with TC based on Mayo criteria were enrolled. Coronary angiography and left ventriculography were performed in all patients and absence of obstructive coronary disease explaining the left ventricular contraction abnormality was confirmed. In-hospital cardiac complications were defined as cardiogenic shock, pulmonary edema, sustained ventricular tachycardia or ventricular fibrillation, complete atrioventricular block, thromboembolism, cardiac rupture, and cardiac death. Multivariate logistic regression analysis was performed to predict in-hospital cardiac complications. Results: In-hospital cardiac complications were observed in 61 patients (40%). There were 25 patients with cardiogenic shock (16%) and 44 patients with pulmonary edema (29%). Sustained ventricular tachycardia or ventricular fibrillation, complete atrioventricular block, and thromboembolism were noted in 10 (7%), 4 (3%) and 4 patients (3%), respectively. Four cardiac deaths (3%) were observed. Of these, one patient died of cardiac rupture. Multivariate logistic regression analysis identified systolic blood pressure (odds ratio=0.97, 95% CI=0.95-0.98, p <0.01), LV ejection fraction (odds ratio=0.95, 95% CI=0.91-0.98, p <0.01), and β-blocker use before admission (odds ratio=8.72, 95%CI=1.00-194.2, p =0.049) as independent predictors of cardiac complications during hospitalization. Conclusion: Low systolic blood pressure and low LV ejection fraction are independent predictors of in-hospital cardiac complications in patients with TC. Furthermore, β-blocker use before admission is associated with worse outcomes during hospitalization.

scholarly journals Delayed reversibility of complete atrioventricular block: cardio-biliary reflex after alcohol septal ablation in a patient with hypertrophic obstructive cardiomyopathy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shu Fang ◽  
Lan Gao ◽  
Fan Yang ◽  
Yan-jun Gong
Keyword(s):  
Abdominal Pain ◽  
Atrioventricular Block ◽  
Normal Sinus Rhythm ◽  
Conduction Block ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Simultaneous Occurrence ◽  
Complete Atrioventricular Block ◽  
Alcohol Septal Ablation ◽  
Complete Atrioventricular

Abstract Background Complete atrioventricular block (AVB) is a life-threatening condition that usually occurs in elderly people with organic heart disease. We herein describe a rare case of complete AVB in a young man with hypertrophic obstructive cardiomyopathy (HOCM) complicated by cholecystitis and cholangitis. Both cardio-biliary reflex and alcohol septal ablation (ASA) can cause conduction block, but the latter is often irreversible. However, their simultaneous occurrence in a patient has not been reported. Case presentation A 31-year-old man presented with acute cholecystitis and cholangitis and complete AVB, which had been diagnosed at a local hospital on the third day after onset. On the fourth day, he was transferred to the emergency department of our hospital because of persistent complete AVB, although his abdominal pain had been partially relieved. An echocardiogram showed a remarkably elevated left ventricular outflow tract (LVOT) gradient (105.2 mmHg) despite the performance of ASA 9 years previously. The abdominal pain gradually disappeared, and normal sinus rhythm was completely recovered 11 days after onset. We determined that cardio-biliary reflex was the cause of the AVB because of the absence of other common causes. Finally, the patient underwent implantation of a permanent pacemaker to reduce the LVOT obstruction and avoid the risk of AVB recurrence. Conclusions Cholecystitis is a rare cause of complete AVB, which is a difficult differential diagnosis when complicated by HOCM after ASA. Clinicians should be alert to the possibility of cholecystitis in patients with abdominal pain and an unknown cause of bradycardia, complete AVB, or even sinus arrest.

Left Ventricular Mechanics and Geometry in Patients With Congenital Complete Atrioventricular Block

Circulation ◽  
1997 ◽  
Vol 96 (10) ◽  
pp. 3430-3435 ◽  
Author(s):  
Naomi J. Kertesz ◽  
Richard A. Friedman ◽  
Steven D. Colan ◽  
Edward P. Walsh ◽  
Robert J. Gajarski ◽  
...  
Keyword(s):  
Atrioventricular Block ◽  
Left Ventricular ◽  
Complete Atrioventricular Block ◽  
Ventricular Mechanics ◽  
Congenital Complete Atrioventricular Block ◽  
Left Ventricular Mechanics ◽  
Complete Atrioventricular

Complete atrioventricular block and reversible systolic dysfunction in left ventricular hypertrabeculation/non-compaction with metabolic myopathy

2010 ◽  
Vol 21 (2) ◽  
pp. 229-232 ◽  
Author(s):  
Claudia Stöllberger ◽  
Josef Finsterer ◽  
Gottfried H. Sodeck ◽  
Franz Weidinger
Keyword(s):  
Atrioventricular Block ◽  
Nicotinamide Adenine Dinucleotide ◽  
Sinus Tachycardia ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Metabolic Myopathy ◽  
Complete Atrioventricular Block ◽  
Echocardiographic Examination ◽  
Reduced Nicotinamide Adenine Dinucleotide ◽  
Complete Atrioventricular

AbstractA 32-year-old female patient presented with cardiac failure because of systolic dysfunction. Five years before, a DDD pacemaker had been implanted because of complete atrioventricular block. Echocardiographic examination disclosed left ventricular hypertrabeculation/non-compaction. Because of sinus tachycardia, ivabradine was started and the patient’s left ventricular function returned to normal within 4 months. Recurrent creatine-kinase elevation and reduced nicotinamide adenine dinucleotide staining on muscle biopsy suggested metabolic myopathy.

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