title: Effect of right ventricular apical pacing in survivors of myocardial infarction.
abstract: BACKGROUND
  Much information is available regarding the possible negative effects of long-term right ventricular (RV) apical pacing, which may cause worsening of heart failure. However, very limited data are available regarding the effects of RV pacing in patients with a previous myocardial infarction (MI).
  
  
  RESULTS
  We screened 115 consecutive post-MI patients and matched a group of 29 pacemaker (PM) recipients with a group of 49 unpaced patients, for age, left ventricular (LV) ejection fraction, and site of MI. During a median follow-up of 54 months, echocardiograms showed a decrease in LV ejection fraction in the paced group, from 51 +/- 10 to 39 +/- 11 (P < 0.01), and a minimal change in the unpaced group, from 57 +/- 8 to 56 +/- 7 (P = 0.98). Similar change was observed in systolic and diastolic diameters and volumes.
  
  
  CONCLUSIONS
  The study showed that, in post-MI patients, RV apical pacing was associated with a worsening of LV function, suggesting that, among MI survivors, the need for a PM is a marker of worse outcome.
authors.affiliation: Electrophysiology and Echocardiography, Department of Cardiology, S.M. Loreto Mare Hospital, Naples, Italy. carminemuto@yahoo.it
authors.forename: Carmine
authors.initials: C
authors.lastname: Muto
authors.forename: Luigi
authors.initials: L
authors.lastname: Ascione
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Canciello
authors.forename: Giovanni
authors.initials: G
authors.lastname: Carreras
authors.forename: Raffaele
authors.initials: R
authors.lastname: Iengo
authors.forename: Luca
authors.initials: L
authors.lastname: Ottaviano
authors.forename: Raimondo
authors.initials: R
authors.lastname: Calvanese
authors.forename: Maria
authors.initials: M
authors.lastname: Accadia
authors.forename: Eduardo
authors.initials: E
authors.lastname: Celentano
authors.forename: Carmine
authors.initials: C
authors.lastname: Ciardiello
authors.forename: Bernardino
authors.initials: B
authors.lastname: Tuccillo
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000517:prevention & control*; D012189:Retrospective Studies; D017741:Survivors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000517:prevention & control*