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Evolution of ventricular function in children with permanent right ventricular pacing after tetralogy of Fallot repair: A midterm follow‐up
Author(s) -
ElShabrawi Mortada,
Lotfy Wael,
Hegazy Ranya,
Abdelaziz Osama,
Sobhy Rodina,
Abdelmohsen Gaser,
Ibrahim Hossam,
Dohain Ahmed M.
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14477
Subject(s) - medicine , tetralogy of fallot , cardiology , qrs complex , ventricular pacing , heart failure , doppler imaging , ventricular function , heart disease , diastole , blood pressure
Objective We aim to evaluate the midterm effect of chronic apical right ventricular (RV) pacing on right and left ventricular (LV) function using different modalities of echocardiography including conventional echocardiography, tissue Doppler imaging and two‐dimension speckle tracking echocardiography. Methods This case‐control study enrolled 49 patients divided into two groups: a paced group and a nonpaced group. The paced group included 23 patients that underwent tetralogy of Fallot (TOF) repair and required permanent pacemaker insertion for postoperative complete heart block. The nonpaced group included 26 patients that had TOF repair at the same period. Results The median age for the paced and nonpaced groups was 6 and 8 years, respectively ( P = .169). The follow‐up duration after TOF surgical repair was 4 years for the paced patients and 5 years for nonpaced patients ( P = .411). In the nonpaced group, the QRS duration increased and LV global longitudinal strain (GLS) decreased significantly with increasing duration after TOF repair, P value was .006 and .042, respectively. In the paced group, tricuspid annular systolic plane excursion (TAPSE) was significantly correlated with age ( r = .578; P = .004) and duration following TOF correction ( r = .724; P < .001). Conclusion Chronic RV apical pacing in children after TOF repair was associated with better clinical status, preservation of RV systolic function, and prevention of progressive QRS prolongation. RV pacing was not associated with progressive deterioration of LV systolic function with increasing the time interval following TOF repair. Therefore, RV pacing can be beneficial in corrected TOF patients presenting with RV failure.