Biventricular Function is Impaired in Right Ventricular Septal Pacing—A Prospective Study Using Myocardial Strain Imaging

Left ventricular (LV) dysfunction is known to occur after right ventricular (RV) pacing; the effect on RV function is less well studied. The aim of this study was to assess the impact of RV mid-septal pacing upon RV function using the novel parameters of speckle-tracking derived RV global longitudin...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2023-03, Vol.32 (3), p.373-378
Main Authors: Toner, Liam, Chen, Janet X.C., Ramchand, Jay, Srivastava, Piyush, O’Donnell, David, Calafiore, Paul, Jones, Elizabeth
Format: Article
Language:English
Subjects:
Echocardiography
Echocardiography - methods
Heart Ventricles - diagnostic imaging
Humans
Pacing
Prospective Studies
Right ventricle
Septal pacing
Strain imaging
Stroke Volume
Ventricular Dysfunction, Right - diagnostic imaging
Ventricular Dysfunction, Right - etiology
Ventricular Function, Left
Ventricular Function, Right
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Summary:Left ventricular (LV) dysfunction is known to occur after right ventricular (RV) pacing; the effect on RV function is less well studied. The aim of this study was to assess the impact of RV mid-septal pacing upon RV function using the novel parameters of speckle-tracking derived RV global longitudinal strain (RV GLS) and RV free wall strain (RV FWS), as well as the conventional parameters RV fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), and tricuspid annular systolic velocity (RV S'). Thirty-two (32) consecutive patients with normal baseline LV and RV function requiring permanent pacemaker insertion (for high-grade AV block or sinus node dysfunction) were prospectively recruited. Echocardiography was performed prior to implantation, at 1 day, 1 month and 1 year after implantation, with 29 patients completing follow-up. After 1 year, three patients (10%) with otherwise normal RV parameters developed abnormal RV strain patterns. Compared to 1 day after implantation, at 1 year significant reductions were observed in mean RV GLS (-24.8 to -21.8%) RV S' (15.1 to 12.2 cm/s), TAPSE (24.2 to 21.9 mm), RV GLS (-24.8 to -21.8%), left ventricular ejection fraction (LVEF) (66.0 to 57.9%), LV GLS (-19.9 to 17.0), all p
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2022.11.004