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- Title
Cardiac resynchronization therapy for pacing induced cardiomyopathy: Role of baseline right ventricular pacing burden.
- Authors
Shahab, Ahmed; Lacy, Sean; Chandler, Jonathan K.; Sheldon, Seth H.; Pimentel, Rhea C.; Dendi, Raghuveer A.; Ramirez, Rigoberto R.; Emert, Martin P.; Berenbom, Loren D.; Reddy, Y. Madhu; Apte, Nachiket; Noheria, Amit
- Abstract
Background: Cardiac resynchronization therapy (CRT) is indicated for patients with heart failure with reduced left ventricular ejection fraction (LVEF) and chronic right ventricular (RV) pacing burden ≥40% (pacing‐induced cardiomyopathy, PICM). It is uncertain whether baseline RV pacing burden impacts response to CRT. Methods: We conducted a retrospective study of all CRT upgrades for PICM at our hospital from January 2017 to December 2018. Univariate and multivariable‐adjusted changes in LVEF, and echocardiographic response (≥10% improvement in LVEF) at 3–12 months post‐CRT upgrade were compared in those with RV pacing burden ≥90% versus <90%. Results: We included 75 patients (age 74 ± 11 years, 71% male) who underwent CRT upgrade for PICM. The baseline RV pacing burden was ≥90% in 56 patients (median 99% [IQR 98%–99%]), and <90% in 19 patients (median 79% [IQR 73%–87%]). Improvement in LVEF was greater in those with baseline RV pacing burden ≥90% versus <90% (15.7 ± 9.3% vs. 7.5 ± 9.6%, p =.003). Baseline RV pacing burden ≥90% was a strong predictor of an improvement in LVEF ≥10% after CRT upgrade both in univariate and multivariate‐adjusted models (p =.005 and.02, respectively). Conclusion: A higher baseline RV pacing burden predicts a greater improvement in LVEF after CRT upgrade for PICM.
- Subjects
TREATMENT of cardiomyopathies; STATISTICS; ECHOCARDIOGRAPHY; VENTRICULAR ejection fraction; RIGHT heart ventricle; MULTIVARIATE analysis; RETROSPECTIVE studies; CARDIAC pacing; RIGHT ventricular dysfunction; DESCRIPTIVE statistics
- Publication
Pacing & Clinical Electrophysiology, 2024, Vol 47, Issue 2, p336
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.14929