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Pacing-induced cardiomyopathy in patients with a high percentage of ventricular pacing: a retrospective study
Session:
SESSÃO DE POSTERS 45 - DISPOSITIVOS CARDÍACOS IMPLANTÁVEIS: COMPLICAÇÕES E SUA PREVENÇÃO
Speaker:
Carla Rafaela de Oliveira Ferreira
Congress:
CPC 2025
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.6 Device Therapy - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Carla Oliveira Ferreira; Inês Rocha; Filipe Silva Vilela; Mónica Dias; Ana Sofia Fernandes; Inês Conde; Cátia Costa Oliveira; Jorge Marques
Abstract
<p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Introduction</strong></span></span></span><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">: Pacemaker implantation is recommended as a treatment for several diseases, mainly atrioventricular block and sinus node disease. Despite all the proven benefits, these devices can result in electromechanical dyssynchrony and, consequently, in pacing-induced cardiomyopathy (PICM), with the predictor most strongly associated with this condition being the percentage of right ventricular pacing (%RVP). The aim of this study is to evaluate the occurrence of Major Adverse Cardiac Events (MACE) in patients with high %RVP (>90%) compared with low %RVP (<10%). </span></span></span></p> <p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Methods</strong></span></span></span><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">: Observational, analytical and retrospective study, which included 889 patients who underwent pacemaker implantation between January 2015 and December 2017 in a tertiary hospital. A 5-year follow-up period was performed. Other causes of left ventricle dysfunction were excluded.</span></span></span></p> <p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Results</strong></span></span></span><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">: The group of patients with RVP>90% (n= 394) was characterized by a higher median age (86 years (10), p<0.001) and a higher proportion of men (62.9%, p=0.001). It presented a lower minimum heart rate (35 bpm (10), p<0,001) and higher NT-proBNP (1789 ng/mL (5227), p<0.001) prior to implantation. The pacemaker indications AVB (77.9% vs. 49.4%) and atrial fibrillation/flutter (17.8% vs. 2,4%) were more prevalent in this group, whereas sinus node dysfunction was more prevalent in RVP<10% (45,4% vs. 4,3%). After 5 years, the RVP>90% group had a higher mortality (36.8% vs. 27,3%) and hospitalization rate due to heart failure (9.1% vs. 3,2%), compared to the RVP<10% group (n= 249).</span></span></span></p> <p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Conclusion</strong></span></span></span><span style="font-size:10pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">: Patients with %RVP>90% have a higher incidence of mortality and re-hospitalization due to heart failure in five years follow-up. Identifying high risk patients and mantaining close follow-up with echocardiographic evaluation after pacemaker implantation is essential for timely detection of PICM.</span></span></span></p>
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