Document Detail

Altered cardiac histology following apical right ventricular pacing in patients with congenital atrioventricular block.
MedLine Citation:
PMID:  10527019     Owner:  NLM     Status:  MEDLINE    
Previous studies have demonstrated that right ventricular apical pacing inherently alters ventricular contraction, regional blood flow, wall stress, and predisposes to diminished function. However, histological consequences of chronic apical pacing potentially contributing to the observed ventricular dysfunction remain conjectural. Previous canine studies have demonstrated histopathological cellular abnormalities with apically initiated ventricular pacing that may result in the observed diminished ventricular function. To determine if comparable adverse changes also occur in the clinical setting, 16 endomyocardial biopsies were obtained from 14 age-matched patients with congenital complete atrioventricular block (CCAVB) and otherwise normal anatomy, divided into two groups: eight biopsies (median patient age 15.5 years) from patients prior to pacemaker implant and another eight biopsies (median patient age 16 years) from patients following 3-12 years (median 5.5) of chronic ventricular pacing. In one patient, biopsy samples were obtained before and after pacing. Results demonstrated a significant (P<0.05) increase in histopathological alterations among the patient biopsy samples following pacing, consisting of myofiber size variation, fibrosis, fat deposition, sclerosis, and mitochondrial morphological changes. These findings indicate that chronic apical right heart ventricular pacing may adversely alter myocellular growth, especially among the young, on the cellular and subcellular level, potentially contributing to the diminished function observed clinically.
P P Karpawich; R Rabah; J E Haas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  22     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-11-15     Completed Date:  1999-11-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1372-7     Citation Subset:  IM    
Section of Cardiology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit 48201, USA.
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MeSH Terms
Biopsy, Needle
Cardiac Pacing, Artificial / adverse effects*,  methods
Child, Preschool
Endocardium / ultrastructure
Heart Block / congenital,  pathology,  physiopathology,  therapy*
Heart Ventricles
Mitochondria, Heart / ultrastructure
Myocardium / ultrastructure*
Ventricular Dysfunction, Right / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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