Why the study?
The precise definition of pacing-induced cardiomyopathy varies across studies, leading to uncertainty regarding the best management approach.
Conduction system pacing is emerging as a potential alternative to biventricular pacing for the management of pacing-induced cardiomyopathy.
Alerts clinicians to PICM risk with chronic RV pacing; leaves open conduction system pacing versus biventricular pacing.
Pacing induced cardiomyopathy (PICM) can occur as a complication due to pacing the right ventricle. Its precise definition varies across different studies, leading to uncertainty as to the best approach for managing this entity. More than 10% of patients who undergo chronic right ventricular pacing develop PICM. Risk factors associated with PICM include reduced left ventricular ejection fraction (LVEF), the proportion of right ventricular pacing, and paced QRS duration. The main approach to treating PICM has been upgrading to biventricular pacing cardiac resynchronization therapy when the LVEF decreases. However, emerging evidence suggest that conduction system pacing might provide an opportunity to manage PICM.
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Kim et al. (2024) studied this question.
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