Pacing-Induced Cardiomyopathy

Shaan Khurshid; David S Frankel

doi:10.1016/j.ccl.2023.03.010

Pacing-Induced Cardiomyopathy

Cardiol Clin. 2023 Aug;41(3):449-461. doi: 10.1016/j.ccl.2023.03.010.

Authors

Shaan Khurshid¹, David S Frankel²

Affiliations

¹ Division of Cardiology and Cardiovascular Research Center, Massachusetts General Hospital, Yawkey 5B Heart Center, 55 Fruit Street, Boston, MA 02114, USA.
² Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, 9 Founders Pavilion, Philadelphia, PA 19104, USA. Electronic address: David.Frankel@pennmedicine.upenn.edu.

PMID: 37321694
DOI: 10.1016/j.ccl.2023.03.010

Abstract

Right ventricular (RV) pacing-induced cardiomyopathy (PICM) is typically defined as left ventricular systolic dysfunction resulting from electrical and mechanical dyssynchrony caused by RV pacing. RV PICM is common, occurring in 10-20% of individuals exposed to frequent RV pacing. Multiple risk factors for PICM have been identified, including male sex, wider native and paced QRS durations, and higher RV pacing percentage, but the ability to predict which individuals will develop PICM remains modest. Biventricular and conduction system pacing, which better preserve electrical and mechanical synchrony, typically prevent the development of PICM and reverse left ventricular systolic dysfunction after PICM has occurred.

Keywords: Heart failure; Pacing; Pacing-induced cardiomyopathy.

Publication types

Review

MeSH terms

Cardiac Pacing, Artificial / adverse effects
Cardiac Pacing, Artificial / methods
Cardiomyopathies* / etiology
Cardiomyopathies* / therapy
Heart Conduction System
Heart Ventricles
Humans
Male
Ventricular Dysfunction, Left* / etiology
Ventricular Function, Left