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Effect of Right Ventricular Apical Pacing in Survivors of Myocardial Infarction |
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| Authors: | CARMINE MUTO,M.D.,LUIGI ASCIONE,M.D.,MICHELANGELO CANCIELLO,M.D.,GIOVANNI CARRERAS,M.D.,RAFFAELE IENGO,M.D.,LUCA OTTAVIANO,M.D.,RAIMONDO CALVANESE,M.D.,MARIA ACCADIA,M.D.,EDUARDO CELENTANO,M.D.,CARMINE CIARDIELLO, Eng,.&dagger BERNARDINO TUCCILLO,M.D. |
| Affiliation: | From the Electrophysiology and Echocardiography, Department of Cardiology, S.M. Loreto Mare Hospital, Naples, Italy;;and Boston Scientific, Genova, Italy |
| Abstract: | Background: Much information is available regarding the possible negative effects of long-term right ventricular (RV) apical pacing, which may cause worsening of heart failure. However, very limited data are available regarding the effects of RV pacing in patients with a previous myocardial infarction (MI). Methods and Results: We screened 115 consecutive post-MI patients and matched a group of 29 pacemaker (PM) recipients with a group of 49 unpaced patients, for age, left ventricular (LV) ejection fraction, and site of MI. During a median follow-up of 54 months, echocardiograms showed a decrease in LV ejection fraction in the paced group, from 51 ± 10 to 39 ± 11 (P < 0.01), and a minimal change in the unpaced group, from 57 ± 8 to 56 ± 7 (P = 0.98). Similar change was observed in systolic and diastolic diameters and volumes. Conclusions: The study showed that, in post-MI patients, RV apical pacing was associated with a worsening of LV function, suggesting that, among MI survivors, the need for a PM is a marker of worse outcome . |
| Keywords: | myocardial infarction permanent pacing right ventricular pacing heart failure |