Nodarse CA, Rodríguez GF, Chávez GE

Language: Spanish
References: 23
Page: 1-16
PDF size: 400.96 Kb.

ABSTRACT

Introduction: Despite their indisputable benefits for the quality of life and life expectancy of patients with precise pacemaker indications, a number of these devices have shown to have deleterious effects in terms of left ventricular function and geometry.
Objective: Identify echocardiographic changes in patients with permanent cardiac stimulation applied from the right ventricular tip.
Methods: A prospective longitudinal descriptive study was conducted of 84 patients requiring permanent pacemaker implantation with stimulation from the right ventricular tip. Echocardiographic data were collected before and after implantation.
Results: Of the total patients, 53.65% were male. Mean age was 68.25 years. An increase was observed in all the means of echocardiographic values except for the left ventricular ejection fraction, which decreased. The sequential stimulation group presented 4 more cases with grade II diastolic dysfunction than at baseline, whereas the group with non-sequential stimulation included 5 grade III diastolic dysfunction cases. Left ventricular ejection fraction lowered 6% in patients with sequential stimulation and 9% in patients with non-sequential stimulation.
Conclusions: Echocardiographic changes during the study showed a group tendency to increase, except for the left ventricular ejection fraction, which decreased.

REFERENCES

1. Muto C, Calvi V, Botto GL, Pecora D, Ciaramitaro G, Valsecchi S, et al. Is there a right place to pace the right ventricle? Evaluation of apical and septal positions in a pacemaker population: study protocol for a prospective intervention-control trial. Contemporary Clinical Trials. 2014;39:320–36.

2. Ahmed M, Gorcsan J, Marek J, Ryo K, Haugaa K, Ludwig DR, et al. Right ventricular apical pacing-induced left ventricular dyssynchrony is associated with a subsequent decline in ejection fraction. Heart Rhythm. 2014;11:602–08.

3. Den Besten T, Sedney MI, Frederiks J, van Hemel NM. Left ventricular dysfunction due to right ventricular stimulation: is biventricular upgrade really necessary? Neth Heart J. 2010;18(12):604-5.

4. Yu CM, Fang F, Luo XX. Long-term follow-up results of the pacing to avoid cardiac enlargement (PACE) trial. Eur J Heart Fail. 2014;16:1016–25.

5. Romero García AR, Fernández Chelala FI, Dominguez Peréz RJ, Santos Hernández A, Arias Salar W. Peculiaridades clínica-epidemiológicas de pacientes sometidos a estimulación cardíaca eléctrica permanente. Correo Científico Médico. 2013;17:443-51.

6. Fang F, Zhang Q, Chan JY. Early pacinginduced systolic dyssynchrony is a strong predictor of left ventricular adverse remodeling: analysis from the Pacing to Avoid Cardiac Enlargement (PACE) trial. Int J Cardiol. 2013;168:723–8.

7. Curtis AB, Worley SJ, Chung ES. Improvement in Clinical Outcomes With Biventricular Versus Right Ventricular Pacing: The BLOCK HF Study. J Am Coll Cardiol. 2016;67:2148–57.

8. Halperin JL, Levine GN, Al-Khatib SM. Further evolution of the ACC/AHA clinical practice guideline recommendation classification system: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2016;67:1572–4.

9. Gillis AM, Russo AM, Ellenbogen KA, Swerdlow ChD, Olshansky B, Al-Khatib SM, et al. HRS/ACCF Expert Consensus Statement on Pacemaker Device and Mode Selection. JACC. 2012;60(7):682-703.

10. Slotwiner DJ, Raitt MH, Del-Carpio Muñoz F, Mulpuru SK, Nasser N, Peterson PN, et al. Impact of Physiologic Pacing Versus Right Ventricular Pacing Among Patients With Left Ventricular Ejection Fraction Greater Than 35 %: A Systematic Review for the 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. JACC. Article In Press. 2019: 74 (7): 988-1008. [acceso 19/07/2019]. Disponible en DOI: https://doi.org/10.1016/j.jacc.2018.10.045

11. Casola Crespo R, Casola Crespo E, Ramírez Lana LJ, Miranda Fragoso AE, Casola García SM, Casola Barreto EP, et al. Registro de implante de marcapasos: trece años de experiencia. Rev. Arch Med Camagüey. 2016;20(2):135-44.

12. Romero-García AR, Domínguez-Pérez RJ, Fernández-Chelala FI, Santos-Hernández AM, Padrosa-Santos D, Arias-Salazar WV, et al. Variables Clínico-Epidemiológicas de la Implantación de Marcapasos Cardíacos en el Hospital Lenin. Holguín, Cuba. 2014;5(1):202-10. DOI: 10.5031/v5i1.RIA10250.

13. Chávez-González E, Barja LD, Ortega DF. Estimulación eléctrica permanente en región septal en pacientes con insuficiencia cardíaca secundaria a estimulación en ápex de ventrículo derecho. Arch Cardiol Mex. 2018;88(5):474-82.

14. Lange JM, Manzolillo H, Parras J, Pozzer D, Pantich R. La estimulación septal del ventrículo derecho generaría igual disincronía biventricular que la estimulación apical en pacientes con fracción de eyección conservada. Archivos de cardiología de México. 2014;84:183-90.

15. Anchante Hernández H, Medina Palomino F, Salazar Cáceres M, Talledo Paredes L, Vega Aponte G, Villanueva Pérez F, et al. Comparación entre estimulación cardíaca en tracto de salida y ápex del ventrículo derecho. Rev Med Hered. 2013;24:6-11.

16. Funck RC, Mueller HH, Lunati M. Characteristics of a large sample of candidates for permanent ventricular pacing included in the Biventricular Pacing for Atrio-ventricular Block to Prevent Cardiac Desynchronization Study (BioPace). Europace. 2014;16:354–62.

17. Brignole M, Botto G, Mont L. Cardiac resynchronization therapy in patients undergoing atrioventricular junction ablation for permanent atrial fibrillation: a randomized trial. Eur Heart J. 2011;32:2420–9.

18. Chan J, Fang F, Zhang Q, Fung J, Razali O, Azlan H, et al. Biventricular pacing is superior to right ventricular pacing in bradycardia patients with preserved systolic function: 2-year results of the PACE trial. Eur Heart J. 2011;32:2533-40.

19. Yu C, Chan J, Zhang Q, Omar R, Yip G, Hussin A, et al. Biventricular pacing in patients with bradycardia and normal ejection fraction. N Engl J Med. 2009;361:2123-34.

20. Vijayaraman P, Bordachar P, Ellenbogen KA. The Continued Search for Physiological Pacing Where Are We Now? JACC. 2017;69(25):3099–114.

21. Nielsen JC, Kristensen L, Andersen HR. A randomized comparison of atrial and dual chamber pacing in 177 consecutive patients with sick sinus syndrome. JACC. 2003;42:614-23.

22. Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt OA, et al. Guía de práctica clínica de la ESC 2013 sobre estimulación cardíaca y terapia de resincronización cardíaca. Rev Esp Cardiol. 2014;67(1):6-14.

23. Abdelrahman M, Subzposh FA, Beer D, Durr B, Naperkowski A, Sun H, et al. Clinical Outcomes of His Bundle Pacing Compared to Right Ventricular Pacing. JACC. 2018;71(2):2319-30.