Atrial Pacing Negatively Affects Left Atrial Morphological and Functional Parameters Similarly to Atrioventricular Dyssynchrony
<i>Background and Objectives</i>: Atrioventricular (AV) dyssynchrony as well as atrial and ventricular pacing affect left atrial (LA) function. We conducted a study evaluating the effect of atrial and ventricular pacing on LA morphological and functional changes after dual-chamber pacema...
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MDPI AG
2024-03-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/60/3/503 |
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| author | Mindaugas Viezelis Gintare Neverauskaite-Piliponiene Agne Marcinkeviciene Tomas Kazakevicius Vytautas Zabiela Vilius Kviesulaitis Renaldas Jurkevicius Aras Puodziukynas |
| author_facet | Mindaugas Viezelis Gintare Neverauskaite-Piliponiene Agne Marcinkeviciene Tomas Kazakevicius Vytautas Zabiela Vilius Kviesulaitis Renaldas Jurkevicius Aras Puodziukynas |
| author_sort | Mindaugas Viezelis |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Atrioventricular (AV) dyssynchrony as well as atrial and ventricular pacing affect left atrial (LA) function. We conducted a study evaluating the effect of atrial and ventricular pacing on LA morphological and functional changes after dual-chamber pacemaker implantation. <i>Materials and Methods</i>: The study prospectively enrolled 121 subjects who had a dual-chamber pacemaker implanted due to sinus node disease (SND) or atrioventricular block (AVB). Subjects were divided into three groups based on indication and pacemaker programming: (1) SND DDDR 60; (2) AVB DDD 60 and (3) AVB DDD 40. Subjects were invited to one- and three-month follow-up visits. Three subsets based on pacing burden were analyzed: (1) high atrial (A) low ventricular (V); (2) high A, high V and (3) low A, high V. LA function was assessed from volumetric parameters and measured strains from echocardiography. <i>Results</i>: The high A, low V group consisted of 38 subjects; while high A, high V had 26 and low A, high V had 23. A significant decrease in reservoir and contractile LA strain parameters were only observed in the high A, low V pacing group after three months (reservoir 25.9 ± 10.3% vs. 21.1 ± 9.9%, <i>p</i> = 0.003, contractile −14.0 ± 9.0% vs. −11.1 ± 7.8, <i>p</i> = 0.018). While the re-established atrioventricular synchrony in the low A, high V group maintained reservoir LA strain at the baseline level after three months (21.4 ± 10.4% vs. 22.5 ± 10.4%, <i>p</i> = 0.975); in the high A, high V group, a further trend to decrease was noted (20.3 ± 8.9% vs. 18.7 ± 8.3%, <i>p</i> = 0.231). <i>Conclusions</i>: High atrial pacing burden independently of atrioventricular dyssynchrony and ventricular pacing impairs LA functional and morphological parameters. Changes appear soon after pacemaker implantation and are maintained. |
| first_indexed | 2024-04-24T18:01:09Z |
| format | Article |
| id | doaj.art-0e68fde204ab4ab39f7b21e594e5bf21 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-04-24T18:01:09Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj.art-0e68fde204ab4ab39f7b21e594e5bf212024-03-27T13:53:51ZengMDPI AGMedicina1010-660X1648-91442024-03-0160350310.3390/medicina60030503Atrial Pacing Negatively Affects Left Atrial Morphological and Functional Parameters Similarly to Atrioventricular DyssynchronyMindaugas Viezelis0Gintare Neverauskaite-Piliponiene1Agne Marcinkeviciene2Tomas Kazakevicius3Vytautas Zabiela4Vilius Kviesulaitis5Renaldas Jurkevicius6Aras Puodziukynas7Department of Cardiology, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 7, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eiveniu Str. 2, LT-50161 Kaunas, LithuaniaDepartment of Cardiology, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 7, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 7, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 7, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Eiveniu Str. 2, LT-50161 Kaunas, LithuaniaDepartment of Cardiology, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 7, LT-44307 Kaunas, LithuaniaDepartment of Cardiology, Lithuanian University of Health Sciences, A. Mickeviciaus Str. 7, LT-44307 Kaunas, Lithuania<i>Background and Objectives</i>: Atrioventricular (AV) dyssynchrony as well as atrial and ventricular pacing affect left atrial (LA) function. We conducted a study evaluating the effect of atrial and ventricular pacing on LA morphological and functional changes after dual-chamber pacemaker implantation. <i>Materials and Methods</i>: The study prospectively enrolled 121 subjects who had a dual-chamber pacemaker implanted due to sinus node disease (SND) or atrioventricular block (AVB). Subjects were divided into three groups based on indication and pacemaker programming: (1) SND DDDR 60; (2) AVB DDD 60 and (3) AVB DDD 40. Subjects were invited to one- and three-month follow-up visits. Three subsets based on pacing burden were analyzed: (1) high atrial (A) low ventricular (V); (2) high A, high V and (3) low A, high V. LA function was assessed from volumetric parameters and measured strains from echocardiography. <i>Results</i>: The high A, low V group consisted of 38 subjects; while high A, high V had 26 and low A, high V had 23. A significant decrease in reservoir and contractile LA strain parameters were only observed in the high A, low V pacing group after three months (reservoir 25.9 ± 10.3% vs. 21.1 ± 9.9%, <i>p</i> = 0.003, contractile −14.0 ± 9.0% vs. −11.1 ± 7.8, <i>p</i> = 0.018). While the re-established atrioventricular synchrony in the low A, high V group maintained reservoir LA strain at the baseline level after three months (21.4 ± 10.4% vs. 22.5 ± 10.4%, <i>p</i> = 0.975); in the high A, high V group, a further trend to decrease was noted (20.3 ± 8.9% vs. 18.7 ± 8.3%, <i>p</i> = 0.231). <i>Conclusions</i>: High atrial pacing burden independently of atrioventricular dyssynchrony and ventricular pacing impairs LA functional and morphological parameters. Changes appear soon after pacemaker implantation and are maintained.https://www.mdpi.com/1648-9144/60/3/503cardiac pacingleft atrial functionstrain |
| spellingShingle | Mindaugas Viezelis Gintare Neverauskaite-Piliponiene Agne Marcinkeviciene Tomas Kazakevicius Vytautas Zabiela Vilius Kviesulaitis Renaldas Jurkevicius Aras Puodziukynas Atrial Pacing Negatively Affects Left Atrial Morphological and Functional Parameters Similarly to Atrioventricular Dyssynchrony Medicina cardiac pacing left atrial function strain |
| title | Atrial Pacing Negatively Affects Left Atrial Morphological and Functional Parameters Similarly to Atrioventricular Dyssynchrony |
| title_full | Atrial Pacing Negatively Affects Left Atrial Morphological and Functional Parameters Similarly to Atrioventricular Dyssynchrony |
| title_fullStr | Atrial Pacing Negatively Affects Left Atrial Morphological and Functional Parameters Similarly to Atrioventricular Dyssynchrony |
| title_full_unstemmed | Atrial Pacing Negatively Affects Left Atrial Morphological and Functional Parameters Similarly to Atrioventricular Dyssynchrony |
| title_short | Atrial Pacing Negatively Affects Left Atrial Morphological and Functional Parameters Similarly to Atrioventricular Dyssynchrony |
| title_sort | atrial pacing negatively affects left atrial morphological and functional parameters similarly to atrioventricular dyssynchrony |
| topic | cardiac pacing left atrial function strain |
| url | https://www.mdpi.com/1648-9144/60/3/503 |
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