Key result
Repositioning the ventricular pacing lead to achieve a normal QRS axis reversed pacing-induced cardiomyopathy, improving left ventricular ejection fraction from 31% to 55% at 1 year.
Case Report (n=1)
Repositioning the right ventricular pacing lead to achieve a normal QRS axis can reverse pacing-induced cardiomyopathy and improve left ventricular systolic function.
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May support lead repositioning in select pacing-induced cardiomyopathy cases; leaves open need for prospective validation.
Right ventricular apical pacing has been a commonly used method for placement of permanent pacemaker, but it is known to be associated with ventricular dyssynchrony and may lead to heart failure. Septal pacing could be an alternative method to improve this complication but the results have been conflicting; hence, other strategies are needed. This case is about a patient with pacing-induced cardiomyopathy who showed much improvement after repositioning the leads to a site different from that of normally paced QRS axis.
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Yang et al. (2016) conducted a case report in Pacing-induced cardiomyopathy (n=1). Normal QRS axis pacing (lead repositioning to septum) vs. Abnormal QRS axis pacing (baseline) was evaluated on Left ventricular ejection fraction (LVEF). Repositioning the ventricular pacing lead to achieve a normal QRS axis reversed pacing-induced cardiomyopathy, improving left ventricular ejection fraction from 31% to 55% at 1 year.
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