title: Quality of life and functional capacity after long-term right ventricular pacing in pediatrics and young adults with congenital atrioventricular block.
abstract: BACKGROUND
  Although several studies have demonstrated deleterious consequences of chronic right ventricular (RV) pacing on ventricular function and synchronicity, its effects on health-related quality of life (HRQoL) and functional exercise capacity remain uncertain. We aimed to evaluate the effect of RV pacing on HRQoL and functional capacity of children and young adults with congenital complete atrioventricular block (CCAVB).
  
  
  METHODS
  We included 66 consecutive subjects with RV cardiac pacemaker due to CCAVB and under clinical follow-up for more than 1 year. Multidimensional HRQoL scores were evaluated by Short Form-36 Health Survey (SF-36) and Child Health Questionnaire-Parent Form 50 (CHQ-PF50). Functional capacity was tested by a 6-minute walk distance test (6MWDT). Association analysis was performed to examine if any demographic and clinical characteristics were associated with lower HRQoL scores and shorter distances at the 6MWDT.
  
  
  RESULTS
  Domains presenting lower HRQoL scores were vitality (64.0 ± 17.3), mental health (67.3 ± 8.0), role emotional (69.7 ± 35.8) in the SF-36 questionnaire; general health perceptions (61.3 ± 8.3), general behavior (61.9 ± 15.6), parental impact-emotional (67.7 ± 28.7) in the CHQ-PF50. Female gender (P = 0.009), left ventricular ejection fraction lower than 55% (P = 0.013), cardiovascular drugs (P = 0.003) were significantly associated with lower HRQoL scores. Average distance traveled during the 6MWDT was 539.8 ± 82.9 m. The 6MWDT showed significant association with age (P = 0.006) and cardiovascular drugs (P = 0.024).
  
  
  CONCLUSIONS
  Chronic RV pacing did not affect the HRQoL and physical capacity of pediatrics and young subjects. Female gender, ventricular function, and cardiovascular drugs were associated with lower HRQoL scores. Older subjects walked shorter distances in the 6MWDT, as well as subjects who were taking cardiovascular drugs.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, North Carolina; Department of Cardiovascular Surgery, Heart Institute (InCor)-Clinics Hospital of the University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Kátia Regina
authors.initials: KR
authors.lastname: Da Silva
authors.forename: Roberto
authors.initials: R
authors.lastname: Costa
authors.forename: Roberto Márcio
authors.initials: RM
authors.lastname: De Oliveira
authors.forename: Marianna Sobral
authors.initials: MS
authors.lastname: Lacerda
authors.forename: Adriana I
authors.initials: AI
authors.lastname: Un Huang
authors.forename: Marina Bertelli
authors.initials: MB
authors.lastname: Rossi
authors.forename: Elizabeth Sartori
authors.initials: ES
authors.lastname: Crevelari
authors.forename: Wagner Tetsuji
authors.initials: WT
authors.lastname: Tamaki
authors.forename: Martino Martinelli
authors.initials: MM
authors.lastname: Filho
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pietrobon
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D054537:Atrioventricular Block / Q000151:congenital* / Q000517:prevention & control / Q000523:psychology*; D002304:Cardiac Pacing, Artificial / Q000379:methods* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D020127:Recovery of Function; D017678:Sex Distribution; D016896:Treatment Outcome; D055815:Young Adult
keywords: 6-minute walk test; cardiac pacing; congenital complete atrioventricular block; pacemaker; pediatrics; quality of life