Ventricular remodeling in right ventricular apical pacing.
| Autor: | Silva RT; Hospital das Clínicas Heart Institute, FMUSP, São Paulo, SP, Brazil. rotasil@ig.com.br, Martinelli Filho M, de Oliveira JC, de Lima CE, Martins DG, Guirao CI, Nishióka SA, Costa R, Sosa EA, Ramires JA |
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| Jazyk: | English; Portuguese |
| Zdroj: | Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2007 Feb; Vol. 88 (2), pp. 152-8. |
| DOI: | 10.1590/s0066-782x2007000200004 |
| Abstrakt: | Objective: To determine ventricular remodeling (VR) and the role of clinical and functional variables in patients with normal cardiac function who underwent right ventricular apical pacing (RVAP). Methods: Among the 268 consecutive patients with standard pacemaker due to complete atrioventricular block (CAVB), those with left ventricular ejection fraction (LVEF) < 55% and left ventricular end-diastolic diameter (LVEDD) > 53 mm on Doppler echocardiography were excluded. Ventricular remodeling was defined as echocardiographic changes documented at least six months after implantation, namely, a >10% increase in LVEDD and a > 20% decrease in LVEF. The following variables were analyzed: underlying heart disease, NYHA functional class of heart failure (HF), time of ventricular stimulation, and QRS duration. Statistical analysis included likelihood ratio test, Fishers exact test, and Wilcoxon rank-sum test. A p value < 0.05 was considered statistically significant. Results: The study included 75 patients, mean age 70.9 +/- 14, of whom 22.6% were male. Mean time between both evaluations was 80.2 months. Before implantation, mean LVEF was 72% and LVEDD was 46 mm; after implantation this values were 69.7% (p = 0.0025) and 48.5 mm (p = 0.0001), respectively. Mean QRS duration after implantation was 156 ms. Ventricular remodeling was observed only in four patients (5.3%), and no exploratory variable specified this behavior. Conclusion: In a long-term follow-up, patients without ventricular dysfunction who underwent RV apical pacing (RVAP) showed low VR rate, and no analyzed variable was associated with its occurrence. |
| Databáze: | MEDLINE |
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