Left ventricular apical pacing in children: feasibility and long-term effect on ventricular function

Abstract Aims  Left ventricular apical pacing (LVAP) has been reported to preserve left ventricular (LV) function in chronically paced children with complete atrioventricular block (CAVB). We sought to evaluate long-term feasibility of LVAP and the effect on LV mechanics and exercise capacity as com...

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Published in:Europace (London, England) England), 2020-02, Vol.22 (2), p.306-313
Main Authors: Kovanda, Jan, Ložek, Miroslav, Ono, Shin, Kubuš, Peter, Tomek, Viktor, Janoušek, Jan
Format: Article
Language:English
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Summary:Abstract Aims  Left ventricular apical pacing (LVAP) has been reported to preserve left ventricular (LV) function in chronically paced children with complete atrioventricular block (CAVB). We sought to evaluate long-term feasibility of LVAP and the effect on LV mechanics and exercise capacity as compared to normal controls. Methods and results  Thirty-six consecutive paediatric patients with CAVB and LVAP in the absence (N = 22) or presence of repaired structural heart disease (N = 14, systemic LV in all) and 25 age-matched normal controls were cross-sectionally studied after a median of 3.9 (interquartile range 2.1–6.8) years of pacing using echocardiography and exercise stress testing. Pacemaker implantation was uneventful and there was no death. Probability of the absence of pacemaker-related surgical revision (elective generator replacement excluded) was 89.0% at 5 years after implantation. Left ventricular apical pacing patients had lower maximum oxygen uptake (P = 0.009), no septal to lateral but significant apical to basal LV mechanical delay (P 
ISSN:1099-5129
1532-2092
DOI:10.1093/europace/euz325