Abstract 1878: R Wave Amplitude in V5, 6 Lead During Pacing Could Predict Heart Failure Worsening in Patients with Permanent Right Ventricular Pacing
It is often observed that right ventricular pacing (RVp) worsens heart failure in patients (pts) who had the pacemaker implantation (PI). We aimed to identify possible predictors of heart failure worsening (HFW) in pts with RVp. We studied 90 patients (48 males, mean age 73±11 yrs) who had PI for atrioventricular block between 1997–2004 and retrospectively assessed the clinical, echocardiographic and electrocardiogrphic variables immediately after PI. During the follow-up periods (58±30 months), 12 patients had heart failure aggravated. Univariate analysis revealed left ventricular ejection fraction, QRS duration, QT interval and R wave amplitude in V5 or V6 as significant variables. On logistic regression analysis, only QRS duration (p<0.05) and R wave amplitude in V5, 6 lead (p<0.01) were independently associated with HFW. Pts with R wave amplitude in V5, 6 >0.25mV had a higher risk of HFW (Figure⇓). None who showed deep S wave in V5, 6 lead had HFW.
Conclusion: R wave amplitude in V5, 6 lead during pacing could be useful to predict HFW in patients with PI, indicating that the intraventricular conduction delay and altered activation leading to dyssynchrony might play a role in HFW in pts with RVp.