Document Detail

Right ventricular pacing is an independent predictor for ventricular tachycardia/ventricular fibrillation occurrence and heart failure events in patients with an implantable cardioverter-defibrillator.
MedLine Citation:
PMID:  18308756     Owner:  NLM     Status:  MEDLINE    
AIMS: There is increasing evidence that right ventricular (RV) pacing may have detrimental effects by increasing morbidity and mortality for heart failure in implantable cardioverter-defibrillator (ICD) patients. In this study we prospectively tested the hypothesis that cumulative RV pacing increases ventricular tachycardia/ventricular fibrillation (VT/VF) occurrence (primary endpoint) and hospitalization and mortality for heart failure (secondary endpoint) in a predominantly secondary prophylactic ICD patient population. METHODS AND RESULTS: Two hundred and fifty patients were divided into two groups according to the median of cumulative RV pacing (< or =2 vs. >2%) and prospectively followed-up for occurrence of primary and secondary endpoints for 18 +/- 4 months. Established predictors for VT/VF occurrence and heart failure events such as age, left ventricular ejection fraction (EF), QRS duration, history of atrial fibrillation, and NT-proBNP were collected at enrollment. Multivariate Cox regression analysis revealed that cumulative RV pacing > 2% and EF < 40% were independent predictors for VT/VF occurrence and heart failure events. Kaplan-Meier analysis showed that patients with >2% cumulative RV pacing more frequently suffered from VT/VF occurrence and heart failure hospitalization. CONCLUSION: Cumulative RV pacing > 2% and EF < 40% are independent predictors for VT/VF occurrence and mortality and hospitalization for heart failure in predominantly secondary prophylactic ICD patients. Our data show that algorithms capable of reducing cumulative RV pacing should be used more frequently in clinical practice.
Ajmal Gardiwal; Hong Yu; Hanno Oswald; Ulrich Luesebrink; Andreas Ludwig; Andreas Maximilian Pichlmaier; Helmut Drexler; Gunnar Klein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  10     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  358-63     Citation Subset:  IM    
Department of Cardiovascular Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany.
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MeSH Terms
Cardiac Pacing, Artificial / adverse effects*,  methods
Cohort Studies
Defibrillators, Implantable / adverse effects*
Follow-Up Studies
Heart Failure / etiology*,  physiopathology
Heart Ventricles / physiopathology*
Kaplan-Meiers Estimate
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain / blood
Peptide Fragments / blood
Predictive Value of Tests
Prospective Studies
Risk Factors
Stroke Volume
Tachycardia, Ventricular / etiology*,  physiopathology
Ventricular Fibrillation / etiology*,  physiopathology
Reg. No./Substance:
0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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