Key result
Dual-chamber pacing triggers pacing-induced cardiomyopathy with a ~20% absolute drop in LVEF.
Why the study?
Single- and dual-chambered pacemakers can cause ventricular dyssynchrony leading to cardiomyopathy, but awareness and timely diagnosis are needed to enable reversible intervention.
Case Report (n=1)
Absolute Event Rate: 35% vs 55%
Alerts clinicians to monitor LVEF post-pacing; leaves open prospective incidence and risk-factor studies.
We present a case of pacing-induced cardiomyopathy. The patient presented with clinical symptoms of dyspnea, leg swelling, and orthopnea several months after a dual-chambered pacemaker was placed for third-degree heart block. The echocardiogram demonstrated a depressed ejection fraction. Coronary angiography was performed, which showed widely patent vessels. Single- and dual-chambered pacemakers create ventricular dyssynchrony, which in turn can cause structural, molecular changes leading to cardiomyopathy. With early intervention of biventricular pacemaker replacement, these changes can be reversible; thus, a timely diagnosis and awareness is warranted.
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Koo et al. (2017) conducted a case report in Pacing-induced cardiomyopathy (n=1). Dual-chambered pacemaker was evaluated on Left ventricular ejection fraction. A 70-year-old female developed pacing-induced cardiomyopathy, evidenced by a decrease in ejection fraction from 55% to 35%, four months after receiving a dual-chambered pacemaker.
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