Impact of right ventricular lead position on left ventricular functions and early remodeling in permanent single- and dual-chamber pacemakers

• Published in: Herzschrittmachertherapie & Elektrophysiologie 2022-12, Vol.33 (4), p.432-439
• Main Authors: Ali, Ahmed Nabil, Hawas, Ahmed Nabih, Ramadan, Ahmed Yehia, Tamara, Ahmed Fathy
• Format: Article
• Language: English
• Subjects: Cardiac Imaging; Cardiac Surgery; Cardiology; Medicine; Medicine & Public Health; Original Contributions
• ISSN: 0938-7412; 1435-1544
• DOI: 10.1007/s00399-022-00896-2

Background Right ventricular (RV) apical pacing can induce both interventricular dyssynchrony and intraventricular dyssynchrony. Mechanical dyssynchrony after long-term RV apical pacing is associated with reduced left ventricular (LV) systolic function and deterioration in functional capacity. Aim We aimed to identify the short-term effects of the pacemaker RV lead position on remodeling of LV systolic functions. Patients and methods The study included 30 patients who presented with an indication of permanent pacing and who underwent permanent single- or dual-chamber pacemaker insertion: 15 patients with RV apical pacing (RV apex), and 15 patients with non-apical pacing (mid-septal). The two-dimensional (2D) speckle tracking imaging technique was used for quantification of global longitudinal function of the left ventricle and dyssynchrony evaluation before pacemaker implantation and after a 3-month follow-up. Results At the 3‑month follow-up, post-pacing 2D speckle tracking echocardiography revealed impairment of global longitudinal strain in all patients and intraventricular dyssynchrony was significantly increased in the apical location compared with the non-apical location (radial dyssynchrony: 108.67 ± 11.68 ms vs. 80.53 ± 8.17 ms, p