Open AccessThe Role of Biventricular Pacing in the Prevention and Therapy of Pacemaker‐Induced Cardiomyopathy
Author(s) -
Guglin Maya,
Barold S. Serge
Publication year - 2015
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12245
Subject(s) - medicine , cardiology , cardiac resynchronization therapy , ventricle , bradycardia , cardiomyopathy , heart failure , cardiac pacing , ejection fraction , ventricular pacing , left bundle branch block , ventricular dyssynchrony , heart rate , blood pressure
Right ventricular (RV) pacing produces well‐known long‐term deleterious effects not only on already compromised, but also on the normal left ventricle (LV). The activation pattern mimicks that of left bundle branch block, with delayed activation of the LV free wall, and results in electrical and mechanical dyssynchrony. Long‐term mandatory (100%) RV pacing, increases LV dimensions and decreases the ejection fraction. Many of these negative effects of pacing can be overcome by biventricular pacing. In this review, we describe the characteristics of pacemaker‐induced cardiomyopathy, its incidence, and the use of cardiac resynchronization therapy (CRT) for its therapy and prevention. The gaps in the current organizational guidelines for using CRT in the treatment of bradycardia are identified, and goals for future research are discussed.