Key result
Worse one-month GLS post-RV pacing predicts pacing-induced LV dysfunction at 12 months.
Why the study?
The study investigated whether GLS measured by 2D STE can predict long-term LV function and identify patients at high risk of pacing-induced LV dysfunction or cardiomyopathy following RV apical pacing.
Does Global Longitudinal Strain (GLS) at one month post pacing predict the development of pacing induced LV dysfunction at 12 months in patients undergoing RV apical pacing?
Cohort (n=47)
No
Does Global Longitudinal Strain (GLS) at one month post pacing predict the development of pacing induced LV dysfunction at 12 months in patients undergoing RV apical pacing?
Absolute Event Rate: -16.94% vs -17.6%
p-value: p=0.02
Global Longitudinal Strain measured at one month post-RV apical pacing can predict the development of pacing-induced left ventricular dysfunction at 12 months.
GLS at 1 month may flag PIVD risk after RV pacing; hypothesis-generating and requires prospective validation before practice change.
OBJECTIVE:The goal of this study is to predict the long term LV function in RV apical paced patients. BACKGROUND:We have used the GLS measured by 2D STE, as a tool to predict the patients who are at high risk of developing pacing induced LV dysfunction (PIVD) or pacing induced cardiomyopathy (PCMP). METHOD: A prospective study conducted in the cardiology department of Government Rajaji Hospital, Madurai, including 47 patients of AV block or sinus node dysfunction with preserved ejection fraction undergoing RV apical pacing. This study population was followed up with serial trans thoracic 2D echocardiography with GLS by STE for a period of 12 months for the development of PIVD (PCMP). RESULTS: Of the study population, 42.5% (n=20) developed PIVD at 12 months and these patients had a signicant fall in their GLS values at one month post pacing. (GLS -16.94% vs -17.60%; p=0.02). CONCLUSION: GLS, a novel echocardiographic parameter can be used as a tool in predicting the decline in ejection fraction following pacemaker implantation with potential to predict the development of PIVD. GLS at one month post pacing had a high predictive accuracy for identifying those who developed PIVD later in the follow up.
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Prithiviraj et al. (2021) conducted a cohort in AV block or sinus node dysfunction with preserved ejection fraction undergoing RV apical pacing (n=47). Global longitudinal strain (GLS) measurement by 2D STE was evaluated on Development of pacing induced LV dysfunction (PIVD) at 12 months (p=0.02). Global longitudinal strain at one month post-RV apical pacing significantly predicted the development of pacing-induced LV dysfunction at 12 months (GLS -16.94% vs -17.60%; p=0.02).
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