Is conventional cardiac pacing harmful in patients with normal ventricular function?
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Data
2013
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Resumo
Background: Right ventricular pacing may be deleterious in patients with left ventricular dysfunction, but in patients
with normal function the impact of this stimulation triggering clinically relevant ventricular dysfunction is not fully
established.
Objectives: To evaluate the clinical, echocardiographic findings of patients with previously normal left ventricular
function underwent implantation of a pacemaker.
Methods: Observational, cross-sectional study with 20 patients, who underwent implantation of pacemaker, prospectively
followed-up, with the following inclusion criteria: normal left ventricular function defined by echocardiography and
ventricular pacing higher than 90%. Were evaluated functional class (FC) (New York Heart Association), 6-minute
walk test (6MWT), B-type natriuretic peptide (BNP), echocardiographic assessment (conventional and dyssynchrony
parameters), and quality of life questionnaire (QLQ) (SF-36). The assessment was performed at ten days (t1), four
months (t2), eight months (t3), 12 months (t4) and 24 months (t5).
Results: Conventional echocardiographic parameters and dyssynchrony parameters showed statistically significant
variation over time. The 6MWT, FC, and BNP showed worsening at the end of two years. QLQ showed initial improvement
and worsening at the end of two years.
Conclusion: The implantation of conventional pacemaker was associated with worsening in functional class, worsening
in walk test, increased BNP levels, increased duration of QRS, and worsening in some domains of the QLQ at the end
of two years. There were no changes in echocardiography measurements (conventional and asynchrony measures).
Descrição
Palavras-chave
Pacemaker, Heart failure, Chagas disease, Septal pacing, Asynchrony
Citação
SÁ, Luiz Antonio Batista de; RASSI, Salvador; BATISTA, MÁrcia Andery Ludovico. Is conventional cardiac pacing harmful in patients with normal ventricular function? Arquivos Brasileiros de Cardiologia, São Paulo, v. 101, n. 6, p. 545-553, 2013.