Pacing induced cardiomyopathy

J Cardiovasc Electrophysiol. 2020 Jan;31(1):286-292. doi: 10.1111/jce.14277. Epub 2019 Nov 25.

Abstract

Pacing induced cardiomyopathy (PICM) is most commonly defined as a drop in left ventricle ejection fraction (LVEF) in the setting of chronic, high burden right ventricle (RV) pacing. Recent data suggest, however, that some individuals may experience the onset of heart failure symptoms more acutely after pacemaker implantation. Definitions of PICM which emphasize drop in LVEF may underestimate the incidence of deleterious effects from RV pacing. Treatment of PICM has primarily focused on upgrade to cardiac resynchronization therapy (CRT) when LVEF has dropped. However, emerging data suggest that conduction system pacing (CSP) may offer an opportunity to prevent PICM in the first place.

Keywords: cardiac resynchronization therapy; cardiomyopathy; conduction system pacing; device upgrade; dyssynchrony; his bundle pacing; left bundle branch block; pacemaker.

MeSH terms

  • Animals
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / physiopathology
  • Arrhythmias, Cardiac / therapy*
  • Cardiac Pacing, Artificial / adverse effects*
  • Cardiac Resynchronization Therapy / adverse effects
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / etiology*
  • Cardiomyopathies / physiopathology
  • Cardiomyopathies / prevention & control
  • Humans
  • Risk Factors
  • Stroke Volume*
  • Treatment Outcome
  • Ventricular Function, Left*
  • Ventricular Function, Right