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The Influence of Right Ventricular Pacing Location, Pacing Burden and Paced QRS Duration to Subclinical Left Ventricular Systolic Dysfunction as Shown by Global Longitudinal Strain Echocardiography

ACTA MEDICA INDONESIANA · Vol. 53 No. 3 (2021)

ISSN
2338-2732, 0125-9326
Terbit
2021-10-04
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng

Abstrak

Background: Prolonged pacing of the right ventricle (RV) is associated with left ventricular (LV) systolic dysfunction. Several studies have shown that the RV pacing location, pacing burden (percentage), and paced QRS duration may affect LV systolic function. Subclinical LV dysfunction may occur early after implantation of a permanent pacemaker (PPM). Therefore, this study aims to detect early subclinical LV systolic dysfunction measured by global longitudinal strain (GLS) using speckle tracking echocardiography (STE) at one month after PPM implantation. Methods: A single-center, prospective cohort study was conducted, and all patients indicated for PPM implantation with preserved LV systolic function were included. Data of RV pacing location (RV apical vs right ventricular outflow tract (RVOT), pacing burden (percentage) (≤40% vs >40%), and paced QRS duration (≤150 ms and >150 ms) were obtained. The change of GLS was also measured before and one month after PPM implantation (delta GLS). Results: 37 patients were enrolled in this study, which demonstrated significant difference between GLS before (-20.30 SD 3.38) and after (-16.93 SD 3.47) PPM implantation (p= 150ms ((1.70 (0.30–8.30) vs 3.45 (0.0–10.5)), p=0.266). Meanwhile, there was a significant difference of delta GLS between patients with pacing burden ≤40% vs >40% (Mean 1.92 SD 1.37 vs 3.98 SD 3.04), p=0.007). Further analysis found that pacing burden only affected the delta GLS in group with apical RV pacing (≤40% (1.58 SD 0.59) vs > 40% (4.67 SD 3.47), p = 0.008) and did not affect the delta GLS in group with RVOT pacing (≤40% (2.32 SD 1.98) vs > 40% (3.29 SD 2.48), p = 0.446). Conclusion: The pacing parameter, particularly pacing burden > 40% may induce the subclinical LV systolic dysfunction after one month of pacemaker implantation as shown by decline of GLS, especially when the RV pacing location was placed on apical.

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Budi SetiabudiawanAfiliasi tidak diketahui1
Guntur DarmawanAfiliasi tidak diketahui1
Laniyati HamijoyoAfiliasi tidak diketahui1
Januar Wibawa MarthaAfiliasi tidak diketahui1
Syarief HidayatAfiliasi tidak diketahui1
Henny TantonoAfiliasi tidak diketahui1
Sylvie SakasasmitaAfiliasi tidak diketahui1
Kevin KarimAfiliasi tidak diketahui1
Sasfia CandrianitaAfiliasi tidak diketahui1
Erica Kwan YueAfiliasi tidak diketahui1
Aang SetiawanAfiliasi tidak diketahui1
Miftah PramudyoAfiliasi tidak diketahui1
Achmad Fauzi YahyaAfiliasi tidak diketahui1
Erwan MartantoAfiliasi tidak diketahui1
Badai B TiksnadiAfiliasi tidak diketahui1
Raissa RafidhinarAfiliasi tidak diketahui1
Gemi Nastiti Indi PutriAfiliasi tidak diketahui1
Ronny LesmanaPadjadjaran University1
Julia Windi GunadiMaranatha Christian University1
Vita Murniati TarawanPadjadjaran University1
Diana Krisanti JasaputraMaranatha Christian University1
Faysal KastellaPadjadjaran University1
Decky GunawanPadjadjaran University1

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
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	<dc:title xml:lang="en-US">The Influence of Right Ventricular Pacing Location, Pacing Burden and Paced QRS Duration to Subclinical Left Ventricular Systolic Dysfunction as Shown by Global Longitudinal Strain Echocardiography</dc:title>
	<dc:creator>Iqbal, Mohammad</dc:creator>
	<dc:creator>Endamatriza, Gadih Ranti</dc:creator>
	<dc:creator>Lampita, Irene</dc:creator>
	<dc:creator>Hendrawansyah, Sindy</dc:creator>
	<dc:creator>Laksono, Sidhi</dc:creator>
	<dc:creator>Hasan, Melawati</dc:creator>
	<dc:creator>Achmad, Chaerul</dc:creator>
	<dc:creator>Karwiky, Giky</dc:creator>
	<dc:creator>Goenawan, Hanna</dc:creator>
	<dc:creator>Akbar, Mohammad Rizki</dc:creator>
	<dc:creator>Kartasasmita, Arief Sjamsulaksan</dc:creator>
	<dc:subject xml:lang="en-US">Right ventricular pacing location</dc:subject>
	<dc:subject xml:lang="en-US">global longitudinal strain</dc:subject>
	<dc:subject xml:lang="en-US">pacing burden</dc:subject>
	<dc:subject xml:lang="en-US">paced QRS duration</dc:subject>
	<dc:subject xml:lang="en-US">Original Article</dc:subject>
	<dc:description xml:lang="en-US">Background: Prolonged pacing of the right ventricle (RV) is associated with left ventricular (LV) systolic dysfunction. Several studies have shown that the RV pacing location, pacing burden (percentage), and paced QRS duration may affect LV systolic function. Subclinical LV dysfunction may occur early after implantation of a permanent pacemaker (PPM). Therefore, this study aims to detect early subclinical LV systolic dysfunction measured by global longitudinal strain (GLS) using speckle tracking echocardiography (STE) at one month after PPM implantation. Methods: A single-center, prospective cohort study was conducted, and all patients indicated for PPM implantation with preserved LV systolic function were included. Data of RV pacing location (RV apical vs right ventricular outflow tract (RVOT), pacing burden (percentage) (≤40% vs &amp;gt;40%), and paced QRS duration (≤150 ms and &amp;gt;150 ms) were obtained. The change of GLS was also measured before and one month after PPM implantation (delta GLS). Results: 37 patients were enrolled in this study, which demonstrated significant difference between GLS before (-20.30 SD 3.38) and after (-16.93 SD 3.47) PPM implantation (p=&amp;lt;0.001). There were no significant difference in delta GLS either between patients with RV pacing location on RV apical vs RVOT ((2.30 (0.00–10.50) vs 2.95(0.10–8.30), p=0.648) or between patient with paced QRS duration ≤150ms vs &amp;gt;150ms ((1.70 (0.30–8.30) vs 3.45 (0.0–10.5)), p=0.266). Meanwhile, there was a significant difference of delta GLS between patients with pacing burden ≤40% vs &amp;gt;40% (Mean 1.92 SD 1.37 vs 3.98 SD 3.04), p=0.007). Further analysis found that pacing burden only affected the delta GLS in group with apical RV pacing (≤40% (1.58 SD 0.59) vs &amp;gt; 40% (4.67 SD 3.47), p = 0.008) and did not affect the delta GLS in group with RVOT pacing (≤40% (2.32 SD 1.98) vs &amp;gt; 40% (3.29 SD 2.48), p = 0.446). Conclusion: The pacing parameter, particularly pacing burden &amp;gt; 40% may induce the subclinical LV systolic dysfunction after one month of pacemaker implantation as shown by decline of GLS,  especially when the RV pacing location was placed on apical.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2021-10-04</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">Prospective cohort study</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/1659</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 53 No. 3 (2021): Acta Medica Indonesiana; 245</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/1659/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2021 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>