Pacing Induced Cardiomyopathy: Diagnosis and Management

Permanent pacemaker is the mainstay treatment indicated for bradycardia caused by sinus node dysfunction. However, heart failure may appear in patients with chronic right ventricle pacing, this is known as Pacing-Induced Cardiomyopathy (PICM). There is no internationally accepted definition for diagnosis of PICM. Studies show the prevalence of PICM is 9% in the first year and increases in proportion to the duration of PPM implantation, but varies widely according to diagnostic criteria used. PICM causes a higher all-cause death, hospital admission, and cardiac death. Therefore, detecting risk factors may be an important part of the prevention and early treatment of PICM. Once PICM develops, several therapy options are available but Cardiac Resynchronization Therapy with biventricular Pacemaker is currently the forefront of treatment. But insight into other more novel therapeutic options such as; His bundle pacing and Left Bundle Branch Pacing shows promising results as an alternative treatment option in the near future.