Effect of right ventricular pacing lead on right heart fuction after permanent pacemaker Implantation

Tóm tắt

Background

There is a discrepancy in incidence of tricuspid regurgitation (TR) ranging from 7 to 39 % after PPM implantation. It has been well known that chronic moderate or severe TR can lead to right ventricular (RV) failure. The aim of this study was to assess the effect of right ventricular pacing lead on right heart function after PPM implantation.

Methods

It was hospital based pre and post, interventional study, including a total of 88 patients who underwent PPM implantation at the Department of Cardiology, Yangon General Hospital, from April 2019 to November 2021. Effect of right ventricular pacing lead was assessed by echocardiographic measurement of TR, right heart structure and right ventricular systolic function at 1 day before PPM implantation and 1 month, 6 months and 12 months after PPM implantation. Within group analysis was calculated by repeated ANOVA test and multiple comparisons were done by Sidek test.

Results

Mean age of this study was 66.9±12.4 years and there was female preponderance (62.5%). There was significant increase in tricuspid regurgitation before and 12 months after PPM implantation (mean PISA from 0.12 cm to 0.21 cm, p < 0.001). Increasing dimensions of right heart (mean RA length from 38.34 mm to 42.54 mm, mean RA diameter from 29.53mm to 33.59 mm, mean RV1 from 29.97 to 33.42 mm, mean RV2 from 25.81mm to 29.08 mm, mean RV3 from 55.1 6mm to 60.12mm) were observed before and 12 months after PPM implantation. Those values were statistically significant in each group (p < 0.001). However, RV function was not reduced until 12 months (mean TAPSE from 25.81mm to 26.03 mm, p = 0.539 and mean RV S’ from 14.52 cm/s to 14.52 cm/s, p = 0.892).

Conclusion

Although dilatation of right heart structure and progression of TR were observed after insertion of right ventricular pacing leads, right ventricular function was maintained at 12 months in this study.