High Incidence of Dilated Cardiomyopathy After Right Ventricular Inlet Pacing in Patients With Congenital Complete Atrioventricular Block.

Abstract

BACKGROUND:

Some patients with congenital complete atrioventricular block (CCAVB) develop dilated cardiomyopathy (DCM) after pacemaker implantation (PMI). We evaluated the relationship between pacing site and DCM incidence.

METHODS AND RESULTS:

We retrospectively evaluated 38 patients with CCAVB; 8 (25%) of 32 patients who had PMI developed DCM/heart failure death (HFD) after PMI, although none of the 6 patients without PMI showed DCM/HFD. All DCM/HFD occurred within 50 months of PMI. Among the 32 patients with PMI, the DCM/HFD incidence was 55% (6/11) for right ventricular inlet (RVI), 18% (2/11) for RV apex (RVA), and 0% for left ventricle (LV) (P=0.013). At the endpoint, the LV ejection fraction and septal-to-posterior wall motion delay of patients with LV pacing were better than those for patients with other pacing sites. Among the 8 DCM/HFD patients, 2 in whom the pacing site was changed from RVI to LV apex or in whom therapy was upgraded to cardiac resynchronization remained alive with no heart failure symptoms, whereas the other 6 died of heart failure.

CONCLUSIONS:

A total of 25% of the patients who underwent PMI because of CCAVB, but none in the non-PMI group, developed DCM/HFD. DCM/HFD incidence was higher in patients with RVI pacing. Ventricular dyssynchrony related to pacing site may be one cause of DCM in patients with CCAVB. (Circ J 2016; 80: 1251-1258).

• Authors: Nobuyuki Tsujii, Aya Miyazaki, Heima Sakaguchi, Koji Kagisaki, Tetsuya Yamamoto, Michio Matsuoka, Yuriko Shima, Hajime Ichikawa, Hideo Ohuchi
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 80 Issue 5 Pg. 1251-8 (Apr 25 2016) ISSN: 1347-4820 [Electronic] Japan
• PMID: 27008922 (Publication Type: Journal Article)

Topics

• Atrioventricular Block (complications, congenital, surgery)
• Cardiac Pacing, Artificial (adverse effects, methods)
• Cardiomyopathy, Dilated (etiology, mortality)
• Heart Failure (etiology, mortality)
• Heart Ventricles (physiopathology)
• Humans
• Incidence
• Retrospective Studies