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Electrocardiography and echocardiography dyssynchrony correlation with left ventricular function in long term permanent pacemaker implantation

Session Poster Session 3

Speaker Ming-Ting Chou

Congress : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure - Diagnostic Methods: Imaging
  • Session type : Poster Session
  • FP Number : P1643

Authors : M-T Chou (Tainan,TW), FY Lin (Tainan,TW), CY Chiang (Tainan,TW)

M-T Chou1 , FY Lin1 , CY Chiang1 , 1Chi-Mei Medical Center, section of Cardiology - Tainan - Taiwan, Province of China ,


Background: Right ventricular pacing(RV) creates electrical dyssynchrony similar to a left-bundle branch block which may have detrimental effects on cardiac structure and function, leading to heart failure in some patients(pts). Several echocardiographic techniques are available for the assessment of cardiac mechanical dyssynchrony. Previous studies had demonstrated using simple ECG parameter as a predictor of pacing-induced left ventricular dysfunction.

Purpose: To evaluate ECG parameter and echocardiographic(echo) dyssynchrony correlation with left ventricular(LV) dysfunction in pts with permanent pacemaker implantation(PPM)

Method: We evaluated 151 pts who had received PPM and were dependent on RV

pacing. The survey included clinical basic data, ECG parameters (pacing axis, QRS duration, QTc interval) and echo studies (LV ejection fraction[EF], LV end systolic dimension[ESD], septal flash, inter-ventricular mechanical delay[IVD], and septal-to-posterior wall motion delay [SPWMD]). Dyssynchrony was assessed by speckle-tracking strain using off-line software.

Results: Pts mean age was 75±13 years old and pacing duration was 79±61 months. Most (94%) RV lead located over apex. Mean LVEF was 61±12%. 11%(17/151) pts had EF below 40%. For ECG parameters, longer QRS and QTc are related with worse LVEF while more negative QRS axis with better EF. For echo parameters, longer SPWMD correlated with worse EF. The finding of septal flash, IVD and speckle tracking dyssynchrony had no significant relation. Duration of QRS also found to have high correlation to SPWMD(P<0.01).

Conclusion: Compared with more time consuming speckle tracking dyssnchrony,  echo SPWMD and ECG parameter correlate better with LVEF in PPM pts.

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