Effect of right ventricular apical pacing in survivors of myocardial infarction.
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.
Muto
Carmine
C
Electrophysiology and Echocardiography, Department of Cardiology, S.M. Loreto Mare Hospital, Naples, Italy. carminemuto@yahoo.it
Ascione
Luigi
L
Canciello
Michelangelo
M
Carreras
Giovanni
G
Iengo
Raffaele
R
Ottaviano
Luca
L
Calvanese
Raimondo
R
Accadia
Maria
M
Celentano
Eduardo
E
Ciardiello
Carmine
C
Tuccillo
Bernardino
B
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*