Circulation. 2004;110:3766-3772
Published online before print December 6, 2004, doi: 10.1161/01.CIR.0000150336.86033.8D
Published online before print December 6, 2004, doi: 10.1161/01.CIR.0000150336.86033.8D
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2004;110:3766-3772.)
© 2004 American Heart Association, Inc.
Congenital Heart Disease |
Detrimental Ventricular Remodeling in Patients With Congenital Complete Heart Block and Chronic Right Ventricular Apical Pacing
From Hôpital cardiologique du Haut Leveque, Pessac, France.
Correspondence to Jean Benoit Thambo, Hôpital Cardiologique du Haut Lévèque, 19 avenue de Magellan, Pessac Cedex 33604 France. E-mail jean-benoit.thambo{at}chu-bordeaux.fr
Received April 23, 2004; revision received August 27, 2004; accepted September 24, 2004.
Background— Although dual-chamber pacing improves cardiac function in patients with complete congenital atrioventricular block (CCAVB) by restoring physiological heart rate and atrioventricular synchronization, the long-term detrimental effect of asynchronous electromechanical activation induced by apical right ventricular pacing (RVP) has not been well clarified.
Methods and Results— Twenty-three CCAVB adults (24±3 years) with a DDD transvenous pacemaker underwent conventional echocardiography before implantation and, after at least 5 years of RVP, an exercise test and echocardiography coupled with tissue Doppler imaging and tissue tracking. They were compared with 30 matched healthy control subjects. After 10±3 years of RVP, CCAVB adults had significantly higher values versus controls in terms of intra-left ventricular (LV) asynchrony (respectively, 59±18 versus 19±9 ms, P<0.001), extent of LV myocardium displaying delayed longitudinal contraction (39±15% versus 10±7%, P<0.01), and septal-to-posterior wall-motion delay (84±26 versus 18±9 ms, P<0.01). The ratio of late-activated posterior to early-activated septal wall thickness was higher after long-term RVP than before (1.3±0.2 vs 1±0.1, P=0.05) and was higher than in controls (1±0.1, P<0.05). The percentage of patients with increased LV end-diastolic diameter was higher after long-term RVP than before implantation and was higher than in controls (57% versus 13%, P<0.05, and 57% versus 0%, P<0.01, respectively). CCAVB patients with long-term RVP had a lower cardiac output than controls (3.8±0.6 versus 4.9±0.8 L/min, P<0.05) and lower exercise performance (123±24 versus 185±39 W, P<0.001).
Conclusions— Prolonged ventricular dyssynchrony induced by long-term endovenous RVP is associated with deleterious LV remodeling, LV dilatation, LV asymmetrical hypertrophy, and low exercise capacity. These new data highlight the importance of the ventricular activation sequence in all patients with chronic ventricular pacing.
Key Words: heart block • pacing • ventricles • imaging • heart defects, congenital
This article has been cited by other articles:
 |
|
 |
|
  C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, December 2, 2008; 118(23): e714 - e833. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Bordachar, X. Iriart, J. Chabaneix, F. Sacher, S. Lafitte, P. Jais, M. Haissaguerre, J. Clementy, P. Dos Santos, and J.-B. Thambo Presence of ventricular dyssynchrony and haemodynamic impact of right ventricular pacing in adults with repaired Tetralogy of Fallot and right bundle branch block Europace, July 4, 2008; (2008) eun178v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Paparella, G. B. Chierchia, A. Sarkozy, A. Francesconi, C. de Asmundis, L. Capulzini, R. Cazzin, and P. Brugada Persistent left superior vena cava in patients treated with His-bundle pacing: trouble or help? Europace, June 16, 2008; (2008) eun170v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. O. Sweeney and F. W. Prinzen Ventricular Pump Function and Pacing: Physiological and Clinical Integration Circ Arrhythmia Electrophysiol, June 1, 2008; 1(2): 127 - 139. [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, D. L. Hayes, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons J. Am. Coll. Cardiol., May 27, 2008; 51(21): e1 - e62. [Full Text] [PDF]
|
|
|
|
|
|
A. E. Epstein, J. P. DiMarco, K. A. Ellenbogen, N.A. M. Estes III, R. A. Freedman, L. S. Gettes, A. M. Gillinov, G. Gregoratos, S. C. Hammill, D. L. Hayes, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): Developed in Collaboration With the American Association for Thoracic Surgery and Society of Thoracic Surgeons Circulation, May 27, 2008; 117(21): e350 - e408. [Full Text] [PDF]
|
|
|
|
 |
|
 I. Garcia-Bolao, B. Lopez, A. Macias, J. J. Gavira, P. Azcarate, and J. Diez Impact of collagen type I turnover on the long-term response to cardiac resynchronization therapy Eur. Heart J., April 1, 2008; 29(7): 898 - 906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Quesada, G. Botto, A. Erdogan, M. Kozak, P. Lercher, J. C. Nielsen, O. Piot, R. Ricci, C. Weiss, D. Becker, et al. Managed ventricular pacing vs. conventional dual-chamber pacing for elective replacements: the PreFER MVP study: clinical background, rationale, and design Europace, March 1, 2008; 10(3): 321 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Albertsen, J. C. Nielsen, S. H. Poulsen, P. T. Mortensen, A. K. Pedersen, P. S. Hansen, H. K. Jensen, and H. Egeblad Biventricular pacing preserves left ventricular performance in patients with high-grade atrio-ventricular block: a randomized comparison with DDD(R) pacing in 50 consecutive patients Europace, March 1, 2008; 10(3): 314 - 320. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Albertsen, J. C. Nielsen, S. H. Poulsen, P. T. Mortensen, A. K. Pedersen, P. S. Hansen, H. K. Jensen, and H. Egeblad DDD(R)-pacing, but not AAI(R)-pacing induces left ventricular desynchronization in patients with sick sinus syndrome: tissue-Doppler and 3D echocardiographic evaluation in a randomized controlled comparison Europace, February 1, 2008; 10(2): 127 - 133. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Lionetti, L. Guiducci, A. Simioniuc, G. D. Aquaro, C. Simi, D. De Marchi, S. Burchielli, L. Pratali, M. Piacenti, M. Lombardi, et al. Mismatch between uniform increase in cardiac glucose uptake and regional contractile dysfunction in pacing-induced heart failure Am J Physiol Heart Circ Physiol, November 1, 2007; 293(5): H2747 - H2756. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Shimano, Y. Tsuji, Y. Yoshida, Y. Inden, N. Tsuboi, T. Itoh, H. Suzuki, T. Muramatsu, T. Okada, S. Harata, et al. Acute and chronic effects of cardiac resynchronization in patients developing heart failure with long-term pacemaker therapy for acquired complete atrioventricular block Europace, October 1, 2007; 9(10): 869 - 874. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Europace, October 1, 2007; 9(10): 959 - 998. [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association Eur. Heart J., September 2, 2007; 28(18): 2256 - 2295. [Full Text] [PDF]
|
|
|
|
|
|
K. Vernooy, R. N.M. Cornelussen, X. A.A.M. Verbeek, W. Y.R. Vanagt, A. van Hunnik, M. Kuiper, T. Arts, H. J.G.M. Crijns, and F. W. Prinzen Cardiac resynchronization therapy cures dyssynchronopathy in canine left bundle-branch block hearts Eur. Heart J., September 1, 2007; 28(17): 2148 - 2155. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. K.G. Winckels, M. B. Thomsen, P. Oosterhoff, A. Oros, J. D.M. Beekman, N. J.M. Attevelt, L. Kretzers, and M. A. Vos High-Septal Pacing Reduces Ventricular Electrical Remodeling and Proarrhythmia in Chronic Atrioventricular Block Dogs J. Am. Coll. Cardiol., August 28, 2007; 50(9): 906 - 913. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-F. Tse and C.-P. Lau Selection of Permanent Ventricular Pacing Site: How Far Should We Go? J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1649 - 1651. [Full Text] [PDF]
|
|
|
|
|
|
L. F. Tops, M. J. Schalij, E. R. Holman, L. van Erven, E. E. van der Wall, and J. J. Bax Right Ventricular Pacing Can Induce Ventricular Dyssynchrony in Patients With Atrial Fibrillation After Atrioventricular Node Ablation J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1642 - 1648. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Lieberman, L. Padeletti, J. Schreuder, K. Jackson, A. Michelucci, A. Colella, W. Eastman, S. Valsecchi, and D. A. Hettrick Ventricular Pacing Lead Location Alters Systemic Hemodynamics and Left Ventricular Function in Patients With and Without Reduced Ejection Fraction J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1634 - 1641. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kindermann, B. Hennen, J. Jung, J. Geisel, M. Bohm, and G. Frohlig Biventricular Versus Conventional Right Ventricular Stimulation for Patients With Standard Pacing Indication and Left Ventricular Dysfunction: The Homburg Biventricular Pacing Evaluation (HOBIPACE) J. Am. Coll. Cardiol., May 16, 2006; 47(10): 1927 - 1937. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. O. Sweeney and A. S. Hellkamp Heart Failure During Cardiac Pacing Circulation, May 2, 2006; 113(17): 2082 - 2088. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G.-P. Diller, D. Okonko, A. Uebing, S. Y. Ho, and M. A. Gatzoulis Cardiac resynchronization therapy for adult congenital heart disease patients with a systemic right ventricle: analysis of feasibility and review of early experience. Europace, April 1, 2006; 8(4): 267 - 272. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Vollmann, L. Luthje, P. Schott, G. Hasenfuss, and C. Unterberg-Buchwald Biventricular Pacing Improves the Blunted Force-Frequency Relation Present During Univentricular Pacing in Patients With Heart Failure and Conduction Delay Circulation, February 21, 2006; 113(7): 953 - 959. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. O. Sweeney and F. W. Prinzen A New Paradigm for Physiologic Ventricular Pacing J. Am. Coll. Cardiol., January 17, 2006; 47(2): 282 - 288. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Helm, L. Younes, M. F. Beg, D. B. Ennis, C. Leclercq, O. P. Faris, E. McVeigh, D. Kass, M. I. Miller, and R. L. Winslow Evidence of Structural Remodeling in the Dyssynchronous Failing Heart Circ. Res., January 6, 2006; 98(1): 125 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Dilaveris, A. Pantazis, G. Giannopoulos, A. Synetos, J. Gialafos, and C. Stefanadis Upgrade to biventricular pacing in patients with pacing-induced heart failure: can resynchronization do the trick? Europace, January 1, 2006; 8(5): 352 - 357. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Dodge-Khatami, A. Kadner, H. Dave, M. Rahn, R. Pretre, and U. Bauersfeld Left heart atrial and ventricular epicardial pacing through a left lateral thoracotomy in children: a safe approach with excellent functional and cosmetic results Eur. J. Cardiothorac. Surg., October 1, 2005; 28(4): 541 - 545. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Abdul-Khaliq, M. Y. Abd El Rahman, W. Hui, J.-B. Thambo, P. Bordachar, S. Garrigue, S. Lafitte, P. Sanders, S. Reuter, R. Girardot, et al. Letter Regarding Article by Thambo et al, "Detrimental Ventricular Remodeling in Patients With Congenital Complete Heart Block and Chronic Right Ventricular Apical Pacing" * Response Circulation, July 26, 2005; 112(4): e70 - e70. [Full Text] [PDF]
|
|