Can left ventricle mass index predict pacemaker-induced cardiomyopathy in patients with dual chamber permanent pacemakers implanted due to complete atrioventricular block?

Pacing induced cardiomyopathy (PICM) occurs due to high-burden right ventricular pacing. In patients with complete atrioventricular (AV) block, it is presumed to have a higher burden of right ventricular pacing. There is a lack of data regarding the relationship between PICM and pre-implantation left ventricular mass index (LVMI).

This study aims to investigate the effect of LVMI on PICM in patients with implanted dual chamber permanent pacemakers (PPM) due to complete AV block.

PPM implanted 577 patients were divided into three groups according to admission LVMI. Mean duration of follow-up was 57±38 months. The baseline characteristics, laboratory and echocardiographic variables were compared between the groups. The independent predictors of PICM incidence and the effect LVMI on PICM were evaluated.

Age, post-implantation QRS duration, left atrium anteroposterior diameter and LVMI were determined to predict long-term PICM. After adjustment for confounding baseline variables, tertile with highest LVMI had 1.9 times higher rates of long-term PICM compared to tertile with lowest LVMI, which was used as the reference group. A ROC analysis showed that the optimal cut-off value of the LVMI to predict long-term PICM was 109.8 mg/m² with 71% sensitivity and 62% specificity (AUC: 0.68; 95% CI: 0.60–0.76; p<0.001),

Pre-implantation LVMI plays an important prognostic role in predicting PICM in patients with implanted dual chamber PPM due to complete AV block.

Type of funding sources: None.