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Subject Area

Cardiology and Vascular Medicine

Article Type

Original Study

Abstract

Background In spite of the fact that the quality of life improved for most patients with a cardiac pacemaker implant, the pacing-induced left bundle branch block pattern can result in changes of the structure, function, and hemodynamics of the heart. Objectives To study the effect of different pacing modes on left ventricular (LV) global and regional longitudinal systolic strain (LSS) by two-dimensional (2-D) speckle-tracking echocardiography. Patients and methods This study was performed on 30 patients with a history of dual-chamber pacemaker implantation of more than 6 months duration and 30 healthy volunteers as controls. Conventional and 2-D speckle-tracking echocardiographies were performed to evaluate the LV global and regional systolic longitudinal strain in different pacing modes. Results Pacemaker programming from atrial sensed ventricular paced mode to atrial paced ventricular paced mode showed a significant decrease in global LV LSS (P = 0.021). Moreover, programming with asynchronous ventricular pacing (VVI mode) demonstrated a further significant reduction of global LV LSS when compared with other pacing modes (P = 0.014). Conclusion Permanent right ventricular apical pacing leads to marked changes of LV systolic function. Moreover, atrial pacing and asynchronous ventricular pacing may cause more deterioration of LV global and regional systolic longitudinal strain detected by 2-D speckle-tracking echocardiography.

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