Abstract 13477: The Effect of Right Ventricular Pacing on Right Ventricular Function and Tricuspid Regurgitation in Right Ventricular Apical Pacing vs Non-apical Pacing
Background: Although right ventricular (RV) pacing is associated with LV dysfunction and dyssynchrony, the effect of pacing on RV function is unknown. RV lead-induced significant tricuspid regurgitation (TR) is associated with adverse outcome. We sought to investigate the effect of pacing on RV function, RV synchrony, and TR, and their association with global LV myocardial deformation.
Methods: We enrolled 145 pts (76 RV apical (RVA) and 69 non-RVA pacing) with preserved ejection fraction and pacemaker implantation because of atrioventricular block (ProtectPACE study). Echo was performed at baseline (just after the implantation) and at 2 years. Tricuspid annular plane systolic excursion (TAPSE), time difference between time to peak TAPSE and time to peak mitral annular plane systolic excursion (TAPSE-dif), visual grading of TR, TR vena contracta (TRVC), and TR peak pressure gradient (TRPG) were assessed. We also measured global longitudinal strain (GLS) using speckle tracking.
Results: Although visual TR grading, TRVC and TRPG significantly worsened after 2years, they showed no significant difference in deterioration between RVA pacing and non-RVA. No temporal change in TAPSE and TAPSE-dif was observed overall, and delta TAPSE and TAPSE-dif were not significantly different between the pacing sites. GLS was significantly impaired after 2years. In a multivariable linear regression, delta TAPSE (but not TR parameters) was significantly associated with the change in GLS (Table).
Conclusion: RV pacing appears to worsen TR, but not RV function. However, these effects were not associated with pacing site. RV dysfunction might be associated with global LV impairment.
Author Disclosures: M. Saito: None. K. Negishi: None. G. Kaye: Research Grant; Modest; Medtronic. T.H. Marwick: Research Grant; Modest; Medtronic.
- © 2014 by American Heart Association, Inc.