Evolution of left ventricular function in paediatric patients with permanent right ventricular pacing for isolated congenital heart block: A medium term follow-up

Radu Vatasescu, Tchavdar Shalganov, Dora Paprika, Laszlo Kornyei, Zsolt Prodan, Gabor Bodor, A. Szatmári, Tamas Szili-Torok

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Aims: We aimed to assess the evolution of left ventricular (LV) systolic function in children with right ventricular apical (RVA) pacing for isolated congenital heart block (ICHB) and to identify possible predictors of LV function deterioration. Right ventricular apical pacing can be detrimental to LV function in a significant number of adults. Effects in children are still controversial. Methods and results: Left ventricular shortening fraction (LV SF) and QRS duration were retrospectively assessed in 45 children with RVA pacing for ICHB: before pacemaker (PM) implantation, immediately after and then regularly during a follow-up of 58.69 ± 45.23 months. Patients were categorized as stable or deteriorators according to an arbitrarily chosen cut-off point of ≥7% decrease in LV SF. Lupus status was unknown. Overall LV SF did not change significantly (41.42% ± 8.21 before pacing, 39.77% ± 7.03 immediately after PM implant, 37.43% ± 9.91 with chronic pacing, P = NS). Deteriorators (n = 13) had significantly higher baseline heart rate (57.5 ± 8.7 vs. 46.9 ± 10.5 bpm, P <0.05) and baseline LV SF (46.17 ± 8.13 vs. 38.4 ± 6.4%; P <0.05), a significantly higher proportion of them being implanted before 2 years of age: 8 of 13 (61.5%) vs. 5 of 25 (20%) in the stable group (P <0.05). Deteriorators had a higher incidence of an initial epicardial lead and narrower native QRS. Conclusion: Permanent RVA pacing for ICHB does not necessarily affect LV function in children. The risk of deterioration of LV function seems to be higher in children with higher baseline heart rate and better baseline LV SF, especially with pacing at a younger age, a narrower native QRS and RVA epicardial pacing site.

Original languageEnglish
Pages (from-to)228-232
Number of pages5
JournalEuropace
Volume9
Issue number4
DOIs
Publication statusPublished - Apr 15 2007

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Left Ventricular Function
Pediatrics
Heart Rate
Congenital heart block
Incidence

Keywords

  • Children
  • Congenital heart block
  • LV systolic function
  • Permanent pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Evolution of left ventricular function in paediatric patients with permanent right ventricular pacing for isolated congenital heart block : A medium term follow-up. / Vatasescu, Radu; Shalganov, Tchavdar; Paprika, Dora; Kornyei, Laszlo; Prodan, Zsolt; Bodor, Gabor; Szatmári, A.; Szili-Torok, Tamas.

In: Europace, Vol. 9, No. 4, 15.04.2007, p. 228-232.

Research output: Contribution to journalArticle

Vatasescu, Radu ; Shalganov, Tchavdar ; Paprika, Dora ; Kornyei, Laszlo ; Prodan, Zsolt ; Bodor, Gabor ; Szatmári, A. ; Szili-Torok, Tamas. / Evolution of left ventricular function in paediatric patients with permanent right ventricular pacing for isolated congenital heart block : A medium term follow-up. In: Europace. 2007 ; Vol. 9, No. 4. pp. 228-232.
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abstract = "Aims: We aimed to assess the evolution of left ventricular (LV) systolic function in children with right ventricular apical (RVA) pacing for isolated congenital heart block (ICHB) and to identify possible predictors of LV function deterioration. Right ventricular apical pacing can be detrimental to LV function in a significant number of adults. Effects in children are still controversial. Methods and results: Left ventricular shortening fraction (LV SF) and QRS duration were retrospectively assessed in 45 children with RVA pacing for ICHB: before pacemaker (PM) implantation, immediately after and then regularly during a follow-up of 58.69 ± 45.23 months. Patients were categorized as stable or deteriorators according to an arbitrarily chosen cut-off point of ≥7{\%} decrease in LV SF. Lupus status was unknown. Overall LV SF did not change significantly (41.42{\%} ± 8.21 before pacing, 39.77{\%} ± 7.03 immediately after PM implant, 37.43{\%} ± 9.91 with chronic pacing, P = NS). Deteriorators (n = 13) had significantly higher baseline heart rate (57.5 ± 8.7 vs. 46.9 ± 10.5 bpm, P <0.05) and baseline LV SF (46.17 ± 8.13 vs. 38.4 ± 6.4{\%}; P <0.05), a significantly higher proportion of them being implanted before 2 years of age: 8 of 13 (61.5{\%}) vs. 5 of 25 (20{\%}) in the stable group (P <0.05). Deteriorators had a higher incidence of an initial epicardial lead and narrower native QRS. Conclusion: Permanent RVA pacing for ICHB does not necessarily affect LV function in children. The risk of deterioration of LV function seems to be higher in children with higher baseline heart rate and better baseline LV SF, especially with pacing at a younger age, a narrower native QRS and RVA epicardial pacing site.",
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T1 - Evolution of left ventricular function in paediatric patients with permanent right ventricular pacing for isolated congenital heart block

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AU - Shalganov, Tchavdar

AU - Paprika, Dora

AU - Kornyei, Laszlo

AU - Prodan, Zsolt

AU - Bodor, Gabor

AU - Szatmári, A.

AU - Szili-Torok, Tamas

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N2 - Aims: We aimed to assess the evolution of left ventricular (LV) systolic function in children with right ventricular apical (RVA) pacing for isolated congenital heart block (ICHB) and to identify possible predictors of LV function deterioration. Right ventricular apical pacing can be detrimental to LV function in a significant number of adults. Effects in children are still controversial. Methods and results: Left ventricular shortening fraction (LV SF) and QRS duration were retrospectively assessed in 45 children with RVA pacing for ICHB: before pacemaker (PM) implantation, immediately after and then regularly during a follow-up of 58.69 ± 45.23 months. Patients were categorized as stable or deteriorators according to an arbitrarily chosen cut-off point of ≥7% decrease in LV SF. Lupus status was unknown. Overall LV SF did not change significantly (41.42% ± 8.21 before pacing, 39.77% ± 7.03 immediately after PM implant, 37.43% ± 9.91 with chronic pacing, P = NS). Deteriorators (n = 13) had significantly higher baseline heart rate (57.5 ± 8.7 vs. 46.9 ± 10.5 bpm, P <0.05) and baseline LV SF (46.17 ± 8.13 vs. 38.4 ± 6.4%; P <0.05), a significantly higher proportion of them being implanted before 2 years of age: 8 of 13 (61.5%) vs. 5 of 25 (20%) in the stable group (P <0.05). Deteriorators had a higher incidence of an initial epicardial lead and narrower native QRS. Conclusion: Permanent RVA pacing for ICHB does not necessarily affect LV function in children. The risk of deterioration of LV function seems to be higher in children with higher baseline heart rate and better baseline LV SF, especially with pacing at a younger age, a narrower native QRS and RVA epicardial pacing site.

AB - Aims: We aimed to assess the evolution of left ventricular (LV) systolic function in children with right ventricular apical (RVA) pacing for isolated congenital heart block (ICHB) and to identify possible predictors of LV function deterioration. Right ventricular apical pacing can be detrimental to LV function in a significant number of adults. Effects in children are still controversial. Methods and results: Left ventricular shortening fraction (LV SF) and QRS duration were retrospectively assessed in 45 children with RVA pacing for ICHB: before pacemaker (PM) implantation, immediately after and then regularly during a follow-up of 58.69 ± 45.23 months. Patients were categorized as stable or deteriorators according to an arbitrarily chosen cut-off point of ≥7% decrease in LV SF. Lupus status was unknown. Overall LV SF did not change significantly (41.42% ± 8.21 before pacing, 39.77% ± 7.03 immediately after PM implant, 37.43% ± 9.91 with chronic pacing, P = NS). Deteriorators (n = 13) had significantly higher baseline heart rate (57.5 ± 8.7 vs. 46.9 ± 10.5 bpm, P <0.05) and baseline LV SF (46.17 ± 8.13 vs. 38.4 ± 6.4%; P <0.05), a significantly higher proportion of them being implanted before 2 years of age: 8 of 13 (61.5%) vs. 5 of 25 (20%) in the stable group (P <0.05). Deteriorators had a higher incidence of an initial epicardial lead and narrower native QRS. Conclusion: Permanent RVA pacing for ICHB does not necessarily affect LV function in children. The risk of deterioration of LV function seems to be higher in children with higher baseline heart rate and better baseline LV SF, especially with pacing at a younger age, a narrower native QRS and RVA epicardial pacing site.

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