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Predictors of an adverse clinical outcome in patients with long-term right ventricular apical pacing

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Author(s)
Jihyun SohnYoung Soo LeeHyung Seob ParkSeongwook HanYoon-Nyun Kim
Keimyung Author(s)
Kim, Yoon NyunPark, Hyoung SeobHan, Seong Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of Cardiology
Issued Date
2017
Volume
70
Issue
5
Keyword
ElectrocardiographyHeart failureRight apical pacing
Abstract
BACKGROUND:

Right ventricular (RV) apical pacing can result in progressive left ventricular (LV) dysfunction and contribute to the development of heart failure (HF). This study aimed to predict the outcome after long-term RV apical pacing in patients with acquired atrioventricular (AV) block who required permanent pacing.

METHODS:

We included 247 patients who underwent long-term (>90% ventricular pacing with atrioventricular synchrony for more than 1 year) RV apical pacing for acquired AV block. We excluded patients with a reduced LV systolic function [ejection fraction (EF) <50%]. The paced QRS duration, degree of the axis, clinical characteristics, laboratory findings, and echocardiographic parameters were recorded. We evaluated the mortality and hospitalization due to HF.

RESULTS:

The mean follow-up duration was 6.9 years. Mortality and hospitalization due to HF occurred in 8.1% and 17%, respectively. In a multivariate analysis, a wider paced QRS duration and less superior paced QRS axis at the time of the implantation were independent risk factors for adverse events. The patients with a paced QRS duration of ≥163ms and axis of ≥-65° had a 5.8 times higher risk for adverse events compared to those with a paced QRS duration of <163ms and axis of <-65°.

CONCLUSIONS:

The paced QRS duration and axis could help us predict adverse clinical outcomes after permanent RV apical pacing in patients with high-degree AV block.
Keimyung Author(s)(Kor)
김윤년
박형섭
한성욱
Publisher
School of Medicine (의과대학)
Citation
Jihyun Sohn et al. (2017). Predictors of an adverse clinical outcome in patients with long-term right ventricular apical pacing. Journal of Cardiology, 70(5), 420–424. doi: 10.1016/j.jjcc.2017.04.008
Type
Article
ISSN
0914-5087
DOI
10.1016/j.jjcc.2017.04.008
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41406
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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