Cardiac resynchronisation therapy in paediatric patients with pacing-induced cardiomyopathy improved mean left ventricular ejection fraction from 43% to 67% and decreased QRS duration.
Observational (n=11)
Does cardiac resynchronization therapy improve echocardiographic and clinical outcomes in pediatric patients with pacing-induced cardiomyopathy?
Cardiac resynchronization therapy significantly improves left ventricular ejection fraction and reduces QRS duration in pediatric patients with pacing-induced cardiomyopathy.
BACKGROUND: Epicardial pacing is a preferred and almost inevitable pacing method, especially in young children, the site of epicardial lead is a major determinant of adverse cardiac remodelling and dysfunction, resulting in a disease termed pacing-induced cardiomyopathy (PICM). This study evaluates the clinical and echocardiographic outcomes of paediatric patients diagnosed with PICM and treated with cardiac resynchronisation therapy. METHODS: A retrospective analysis was conducted on paediatric patients (≤18 years) diagnosed with PICM and resynchronised between 2006 and 2024. Demographic, clinical, electrocardiographic, and echocardiographic data were collected. Echocardiographic assessments included left ventricular ejection fraction (LVEF), fractional shortening (FS), and ventricular diameters. RESULTS: Eleven patients (mean age: 5.7 ± 4.3 years) were identified. The mean time for the development of LV dysfunction was 28.1 ± 28.8 months. All patients had pacing percentage of 100%, with a mean QRS duration of 164 ± 23 msec and LVEF of 43 ± 15% at diagnosis. The site of pacing was the right ventricular free wall in 6/11 and outflow in 4/11 patients. Following resynchronisation, LVEF improved to 67 ± 6%, FS increased to 37 ± 4%, and QRS duration decreased to 129 ± 24 msec. BNP levels significantly declined, and no procedural complications occurred. CONCLUSION: Although lead implantation in the right ventricular anterior wall may be technically feasible through the existing incision in the early postoperative period, it should be avoided due to the risk of potential complications and the likelihood of requiring additional interventions in the future.
Öztürk et al. (Sat,) conducted a observational in Pacing-induced cardiomyopathy (PICM) (n=11). Cardiac resynchronisation therapy was evaluated on Clinical and echocardiographic outcomes (LVEF, FS, QRS duration). Cardiac resynchronisation therapy in paediatric patients with pacing-induced cardiomyopathy improved mean left ventricular ejection fraction from 43% to 67% and decreased QRS duration.