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Dilated cardiomyopathy after long-term right ventricular apical pacing in children with complete atrioventricular block: role of setting of ventricular pacing.
MedLine Citation:
PMID:  19786257     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Pediatric patients paced for complete atrioventricular block (CAVB) are at risk of developing dilated cardiomyopathy (DCM). We sought to explore the role played by the setting of ventricular pacing. METHODS AND RESULTS: A total of 35 patients <18 years of age at diagnosis were enrolled. Twenty-eight (80%) received pacemakers after a mean follow-up of 10 years, and most were paced from right ventricular (RV) apex (n = 23). None of the 7 patients without pacemakers developed DCM, whereas 8 (35%) paced from RV apex had DCM 2.6 +/- 2.2 years after pacing. The percentage of ventricular pacing was >90% in all patients. Multivariate analysis revealed that the cumulative Z score of lower ventricular rate setting was the single most important risk factor for DCM (HR, 3.14; 95% CI, 1.07-9.19; P = .037). Subgroup analysis in patients with VVI/VVIR modes revealed an even stronger predictive value of the cumulative Z score of lower ventricular rate setting (HR, 9.12; 95% CI, 1.53-54.24; P = .015). CONCLUSIONS: Higher setting of the lower ventricular rate, though still within the age-appropriate range, was associated with increased risk of developing DCM in pediatric patients with CAVB and chronic RV apical pacing.
Authors:
Chun-An Chen; Jou-Kou Wang; Ming-Tai Lin; Chun-Wei Lu; Kun-Lang Wu; Shuenn-Nan Chiu; Hsin-Hui Chiu; En-Ting Wu; Hung-Chi Lue; Mei-Hwan Wu
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Publication Detail:
Type:  Journal Article     Date:  2009-05-22
Journal Detail:
Title:  Journal of cardiac failure     Volume:  15     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  681-8     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
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