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Article: Left ventricular apical akinetic aneurysmatic area associated with permanent right ventricular apical pacing for advanced atrioventricular block: Clinical characteristics and long-term outcome

TitleLeft ventricular apical akinetic aneurysmatic area associated with permanent right ventricular apical pacing for advanced atrioventricular block: Clinical characteristics and long-term outcome
Authors
KeywordsArrhythmia
Heart failure
Pacing
Issue Date2011
PublisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/
Citation
Europace, 2011, v. 13 n. 4, p. 514-519 How to Cite?
AbstractBackground: Right ventricular apical (RVA) pacing can induce left ventricular (LV) dyssynchrony and dysfunction. In this article, we describe the prevalence, clinical characteristics, and outcome in a subset of patients with unrecognized LV apical akinetic aneurysmatic area associated with permanent RVA pacing as potential causes of heart failure (HF) and/or ventricular tachyarrhythmias (VT). Methods and results: We retrospectively studied 220 patients with permanent RVA pacing and no pre-existing structural heart disease in our follow-up clinic for high-degree atrioventricular block. Patients who presented with new-onset HF, chest pain, or VT following RVA pacing were evaluated by echocardiogram and cardiac catheterization. RVA pacing-induced LV apical akinetic aneurysmatic area was diagnosed in the absence of significant coronary artery disease by left ventriculogram. After a mean 8.8 ± 6.3 years, eight patients (3.6%) had LV apical akinetic aneurysmatic area. Of those with LV apical akinetic aneurysmatic area, four patients presented with or died of VT. There was no evidence of LV apical akinetic aneurysmatic area on echocardiogram or left ventriculogram in the remaining 212 patients. The four patients with LV apical akinetic aneurysmatic area and HF underwent cardiac resynchronization therapy: in all cases LV ejection fraction improved (from 33 ± 6 to 47 ± 10%, P = 0.03), and LV apical akinetic aneurysmatic area resolved in two. Conclusion: Permanent RVA pacing for high-degree atrioventricular block is associated with LV apical akinetic aneurysmatic area. This condition was associated with a high incidence of VT and cardiovascular complication, but was possibly reversible with cardiac resynchronization therapy. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2011.
Persistent Identifierhttp://hdl.handle.net/10722/139462
ISSN
2015 Impact Factor: 4.021
2015 SCImago Journal Rankings: 2.201
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYiu, KHen_HK
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorZhang, XHen_HK
dc.contributor.authorWang, Men_HK
dc.contributor.authorLee, KLen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorTse, HFen_HK
dc.date.accessioned2011-09-23T05:50:20Z-
dc.date.available2011-09-23T05:50:20Z-
dc.date.issued2011en_HK
dc.identifier.citationEuropace, 2011, v. 13 n. 4, p. 514-519en_HK
dc.identifier.issn1099-5129en_HK
dc.identifier.urihttp://hdl.handle.net/10722/139462-
dc.description.abstractBackground: Right ventricular apical (RVA) pacing can induce left ventricular (LV) dyssynchrony and dysfunction. In this article, we describe the prevalence, clinical characteristics, and outcome in a subset of patients with unrecognized LV apical akinetic aneurysmatic area associated with permanent RVA pacing as potential causes of heart failure (HF) and/or ventricular tachyarrhythmias (VT). Methods and results: We retrospectively studied 220 patients with permanent RVA pacing and no pre-existing structural heart disease in our follow-up clinic for high-degree atrioventricular block. Patients who presented with new-onset HF, chest pain, or VT following RVA pacing were evaluated by echocardiogram and cardiac catheterization. RVA pacing-induced LV apical akinetic aneurysmatic area was diagnosed in the absence of significant coronary artery disease by left ventriculogram. After a mean 8.8 ± 6.3 years, eight patients (3.6%) had LV apical akinetic aneurysmatic area. Of those with LV apical akinetic aneurysmatic area, four patients presented with or died of VT. There was no evidence of LV apical akinetic aneurysmatic area on echocardiogram or left ventriculogram in the remaining 212 patients. The four patients with LV apical akinetic aneurysmatic area and HF underwent cardiac resynchronization therapy: in all cases LV ejection fraction improved (from 33 ± 6 to 47 ± 10%, P = 0.03), and LV apical akinetic aneurysmatic area resolved in two. Conclusion: Permanent RVA pacing for high-degree atrioventricular block is associated with LV apical akinetic aneurysmatic area. This condition was associated with a high incidence of VT and cardiovascular complication, but was possibly reversible with cardiac resynchronization therapy. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2011.en_HK
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://europace.oxfordjournals.org/en_HK
dc.relation.ispartofEuropaceen_HK
dc.subjectArrhythmiaen_HK
dc.subjectHeart failureen_HK
dc.subjectPacingen_HK
dc.subject.meshAtrioventricular Block - therapy-
dc.subject.meshCardiac Pacing, Artificial - adverse effects - methods-
dc.subject.meshHeart Failure - epidemiology - etiology - therapy-
dc.subject.meshVentricular Dysfunction, Left - epidemiology - etiology - therapy-
dc.subject.meshVentricular Function, Right - physiology-
dc.titleLeft ventricular apical akinetic aneurysmatic area associated with permanent right ventricular apical pacing for advanced atrioventricular block: Clinical characteristics and long-term outcomeen_HK
dc.typeArticleen_HK
dc.identifier.emailYiu, KH:khkyiu@hku.hken_HK
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_HK
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityYiu, KH=rp01490en_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.identifier.authorityWang, M=rp00281en_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1093/europace/euq521en_HK
dc.identifier.pmid21296775en_HK
dc.identifier.scopuseid_2-s2.0-79953785591en_HK
dc.identifier.hkuros194354en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79953785591&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume13en_HK
dc.identifier.issue4en_HK
dc.identifier.spage514en_HK
dc.identifier.epage519en_HK
dc.identifier.eissn1532-2092-
dc.identifier.isiWOS:000289163500015-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridYiu, KH=35172267800en_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridZhang, XH=48661641200en_HK
dc.identifier.scopusauthoridWang, M=7406690398en_HK
dc.identifier.scopusauthoridLee, KL=7501505962en_HK
dc.identifier.scopusauthoridLau, CP=35275317200en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK

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