Abstract
To identify risk factors for left ventricular (LV) dysfunction in right ventricular (RV) pacing in the young. Left ventricular function was evaluated in 82 paediatric patients with either non-surgical (n = 41) or surgical (n= 41) complete atrioventricular block who have been 100% RV paced for a mean period of 7.4 years.
Left ventricular shortening fraction (SF) decreased from a median (range) of 39 (24-62)% prior to implantation to 32 (8-49)% at last follow-up (P +2z-values) and dysfunction (SF < 0.26) was found to increase from 1.3% prior to pacemaker implantation to 13.4% (11/82 patients) at last follow-up (P = 0.01). Ten of these 11 patients had progressive LV remodelling and 8 of 11 were symptomatic.
The only significant risk factor for the development of LV dilatation and dysfunction was the presence of epicardial RV free wall pacing (OR = 14.3, P < 0.001). Other pre-implantation demographic, diagnostic,