Impact of the permanent ventricular pacing site on left ventricular function in children: a retrospective multicentre survey

Irene E. van Geldorp*, Tammo Delhaas, Roman A. Gebauer, Patrick Frias, Maren Tomaske, Mark K. Friedberg, Svjetlana Tisma-Dupanovic, Jan Elders, Andreas Fruh, Fulvio Gabbarini, Petr Kubus, Viera Illikova, Sabrina Tsao, Andreas Christian Blank, Anita Hiippala, Thierry Sluysmans, Peter Karpawich, Sally-Ann Clur, Xavier Ganame, Kathryn K. CollinsGisela Dann, Jean-Benoit Thambo, Conceicao Trigo, Bert Nagel, John Papagiannis, Annette Rackowitz, Jan Marek, Jan-Hendrik Nuernberg, Ward Y. Vanagt, Frits W. Prinzen, Jan Janousek

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background Chronic right ventricular (RV) pacing is associated with deleterious effects on cardiac function. Objective In an observational multicentre study in children with isolated atrioventricular (AV) block receiving chronic ventricular pacing, the importance of the ventricular pacing site on left ventricular (LV) function was investigated. Methods Demographics, maternal autoantibody status and echocardiographic measurements on LV end-diastolic and end-systolic dimensions and volumes at age <18 years were retrospectively collected from patients undergoing chronic ventricular pacing (> 1 year) for isolated AV block. LV fractional shortening (LVFS) and, if possible LV ejection fraction (LVEF) were calculated. Linear regression analyses were adjusted for patient characteristics. Results From 27 centres, 297 children were included, in whom pacing was applied at the RV epicardium (RVepi, n = 147), RV endocardium (RVendo, n = 113) or LV epicardium (LVepi, n = 37). LVFS was significantly affected by pacing site (p = 0.001), and not by maternal autoantibody status (p = 0.266). LVFS in LVepi (39 +/- 5%) was significantly higher than in RVendo (33 +/- 7%, p<0.001) and RVepi (35 +/- 8%, p = 0.001; no significant difference between RV-paced groups, p = 0.275). Subnormal LVFS (LVFS= 28%) in all LVepi-paced children (p = 0.049). These results are supported by the findings for LVEF (n = 122): LVEF was <50% in 17/69 (25%) RVendo- and in 10/35 (29%) RVepi-paced patients, while LVEF was <50% in 17/18 (94%) LVepi-paced patients. Conclusion In children with isolated AV block, permanent ventricular pacing site is an important determinant of LV function, with LVFS being significantly higher with LV pacing than with RV pacing.
Original languageEnglish
Pages (from-to)2051-2055
JournalHeart
Volume97
Issue number24
DOIs
Publication statusPublished - Dec 2011

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