Reversal of Pacing-Induced Cardiomyopathy Following Cardiac Resynchronization Therapy

JACC. Clinical Electrophysiology
Shaan KhurshidDavid S Frankel

Abstract

This study sought to determine the extent, time course, and predictors of improvement following cardiac resynchronization therapy (CRT) upgrade among pacing-induced cardiomyopathy (PICM) patients. PICM is an important cause of heart failure in patients exposed to frequent right ventricular (RV) pacing. CRT may reverse PICM. We retrospectively studied 1,279 consecutive patients undergoing CRT procedures between 2003 and 2016. Patients undergoing CRT upgrade from a dual-chamber or single-chamber ventricular pacemaker for PICM were included. PICM was defined as decrease of ≥10% in left ventricular ejection fraction (LVEF), resulting in LVEF <50% among patients experiencing ≥20% RV pacing without an alternative cause of cardiomyopathy. Severe PICM was defined as pre-upgrade LVEF ≤35%. Clinical, electrocardiographic, and echocardiographic characteristics associated with both the extent of LVEF recovery and with post-upgrade LVEF of >35% among those with severe PICM were identified. Of 69 PICM patients, LVEF improved from 29.3% to 45.3% over a median 7.0 months. Of 54 patients with severe PICM, 39 (72.2%) improved to LVEF >35% over a median 7.0 months. Most improvement occurred within the first 3 months, although improvement continue...Continue Reading

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Citations

Nov 15, 2019·Journal of Cardiovascular Electrophysiology·Faisal M Merchant, Suneet Mittal
Oct 28, 2019·Journal of Cardiovascular Electrophysiology·Gerry Kaye
Nov 14, 2019·The Journal of Physiology·Erin L O'CallaghanJulian F R Paton
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Mar 22, 2020·Pacing and Clinical Electrophysiology : PACE·Danuta LobodaKrzysztof S Golba
Feb 9, 2019·European Journal of Heart Failure·Sung Woo ChoSeung-Jung Park
Sep 13, 2019·Journal of Cardiovascular Electrophysiology·Thibaud LacourNicolas Clementy
Jan 8, 2019·Chinese Medical Journal·Li-Ting ChengYong-Quan Wu
Dec 30, 2020·Pacing and Clinical Electrophysiology : PACE·Zhiyong QianJiangang Zou
Aug 20, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Amr AbdinChris P Gale
Aug 30, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Michael GliksonKlaus K Witte
Aug 30, 2021·European Heart Journal·Michael GliksonUNKNOWN ESC Scientific Document Group
Sep 28, 2021·Journal of Cardiovascular Electrophysiology·Giacomo M CioffiGiovanni Battista Forleo
Oct 15, 2021·BMJ Case Reports·Claire SeydouxHari Vivekanantham
Sep 2, 2021·Current Cardiology Reviews·Callan Gavaghan

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