Key result
Switching from atrial-sensed to atrial-paced or VVI pacing is linked to reduced LV global longitudinal strain.
Why the study?
Although cardiac pacemakers improve quality of life, pacing-induced left bundle branch block patterns can alter cardiac structure, function, and hemodynamics.
Do different pacing modes (AS-VP, AP-VP, VVI) affect LV global and regional longitudinal systolic strain in patients with dual chamber pacemakers?
Observational (n=60)
Do different pacing modes (AS-VP, AP-VP, VVI) affect LV global and regional longitudinal systolic strain in patients with dual chamber pacemakers?
p-value: p=<0.05
Asynchronous ventricular pacing (VVI) and atrial paced-ventricular paced (AP-VP) modes cause greater deterioration in LV longitudinal systolic strain compared to atrial sensed-ventricular paced (AS-VP) mode.
Pacing mode may influence LV strain and warrants consideration in programming; leaves open whether optimization affects clinical outcomes.
Background Inspite of the fact that the life quality improved for most patients with a cardiac pacemaker implant, the pacing induced left bundle branch block pattern can result in changes of the structure, function and hemodynamic of the heart. Methods: This study was performed on 30 patients with history of dual chamber pacemaker implantation more than 6 months duration and 30 healthy volunteers as controls. Conventional and 2-D speckle tracking echocardiography were performed to evaluate the LV global and regional systolic longitudinal strain in different pacing modes. Results: Pacemaker programming from atrial sensed-ventricular paced mode (AS-VP mode) to atrial paced-ventricular paced mode (AP-VP) showed a significant decrease in global LV longitudinal systolic strain (P value <0.05). Moreover, programming to asynchronous ventricular pacing (VVI mode) demonstrated a further significant reduction of global LV LSS when compared to other pacing modes (P value <0.05). Conclusion: Permanent RV apical pacing leads to marked changes of LV systolic function. Moreover, atrial pacing and asynchronous ventricular pacing may cause more deterioration of LV global and regional systolic longitudinal strain detected by 2-D speckle tracking echocardiography.
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Yaseen et al. (2022) conducted an observational in Dual chamber pacemaker implantation (n=60). Different pacing modes (AS-VP, AP-VP, VVI) vs. Other pacing modes and healthy controls was evaluated on LV global and regional systolic longitudinal strain (p=<0.05). Changing pacemaker programming from atrial sensed-ventricular paced to atrial paced-ventricular paced or VVI mode significantly decreased global LV longitudinal systolic strain (P<0.05).
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