Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development
ABSTRACT Coordinated and harmonic (synchronous) ventricular electrical activation is essential for better left ventricular systolic function. Intraventricular conduction abnormalities, such as left bundle branch block due to artificial cardiac pacing, lead to electromechanical “dyssynchronopathy” wi...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Cirurgia Cardiovascular
2022-12-01
|
| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022005009201&tlng=en |
| _version_ | 1811179241060958208 |
|---|---|
| author | Andres Di Leoni Ferrari Eduardo Bartholomay Oliveira Ana Paula Tagliari Adriano Nunes Kochi Thaís Mariel Andara Beuren Gustavo Chiari Cabral Flávio Vinicius Costa Ferreira Luiz Cláudio Danzmann |
| author_facet | Andres Di Leoni Ferrari Eduardo Bartholomay Oliveira Ana Paula Tagliari Adriano Nunes Kochi Thaís Mariel Andara Beuren Gustavo Chiari Cabral Flávio Vinicius Costa Ferreira Luiz Cláudio Danzmann |
| author_sort | Andres Di Leoni Ferrari |
| collection | DOAJ |
| description | ABSTRACT Coordinated and harmonic (synchronous) ventricular electrical activation is essential for better left ventricular systolic function. Intraventricular conduction abnormalities, such as left bundle branch block due to artificial cardiac pacing, lead to electromechanical “dyssynchronopathy” with deleterious structural and clinical consequences. The aim of this review was to describe and improve the understanding of all the processes connecting the several mechanisms involved in the development of artificially induced ventricular dyssynchrony by cardiac pacing, most known as pacing-induced cardiomyopathy (PiCM). The chronic effect of abnormal impulse conduction and nonphysiological ectopic activation by artificial cardiac pacing is suspected to affect metabolism and myocardial perfusion, triggering regional differences in the activation/contraction processes that cause electrical and structural remodeling due to damage, inflammation, and fibrosis of the cardiac tissue. The effect of artificial cardiac pacing on ventricular function and structure can be multifactorial, and biological factors underlying PiCM could affect the time and probability of developing the condition. PiCM has not been included in the traditional classification of cardiomyopathies, which can hinder detection. This article reviews the available evidence for pacing-induced cardiovascular disease, the current understanding of its pathophysiology, and reinforces the adverse effects of right ventricular pacing, especially right ventricular pacing burden (commonly measured in percentage) and its repercussion on ventricular contraction (reflected by the impact on left ventricular systolic function). These effects might be the main defining criteria and determining mechanisms of the pathophysiology and the clinical repercussion seen on patients. |
| first_indexed | 2024-04-11T06:32:32Z |
| format | Article |
| id | doaj.art-449cb8a748fa462d866d166c9bef4f6e |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-04-11T06:32:32Z |
| publishDate | 2022-12-01 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-449cb8a748fa462d866d166c9bef4f6e2022-12-22T04:39:59ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412022-12-0110.21470/1678-9741-2021-0629Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure DevelopmentAndres Di Leoni Ferrarihttps://orcid.org/0000-0001-8975-7912Eduardo Bartholomay OliveiraAna Paula TagliariAdriano Nunes KochiThaís Mariel Andara BeurenGustavo Chiari CabralFlávio Vinicius Costa FerreiraLuiz Cláudio DanzmannABSTRACT Coordinated and harmonic (synchronous) ventricular electrical activation is essential for better left ventricular systolic function. Intraventricular conduction abnormalities, such as left bundle branch block due to artificial cardiac pacing, lead to electromechanical “dyssynchronopathy” with deleterious structural and clinical consequences. The aim of this review was to describe and improve the understanding of all the processes connecting the several mechanisms involved in the development of artificially induced ventricular dyssynchrony by cardiac pacing, most known as pacing-induced cardiomyopathy (PiCM). The chronic effect of abnormal impulse conduction and nonphysiological ectopic activation by artificial cardiac pacing is suspected to affect metabolism and myocardial perfusion, triggering regional differences in the activation/contraction processes that cause electrical and structural remodeling due to damage, inflammation, and fibrosis of the cardiac tissue. The effect of artificial cardiac pacing on ventricular function and structure can be multifactorial, and biological factors underlying PiCM could affect the time and probability of developing the condition. PiCM has not been included in the traditional classification of cardiomyopathies, which can hinder detection. This article reviews the available evidence for pacing-induced cardiovascular disease, the current understanding of its pathophysiology, and reinforces the adverse effects of right ventricular pacing, especially right ventricular pacing burden (commonly measured in percentage) and its repercussion on ventricular contraction (reflected by the impact on left ventricular systolic function). These effects might be the main defining criteria and determining mechanisms of the pathophysiology and the clinical repercussion seen on patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022005009201&tlng=enHeart FailureCardiac PacingArtificialCardiomyopathiesVentricular FunctionBiological Factors. |
| spellingShingle | Andres Di Leoni Ferrari Eduardo Bartholomay Oliveira Ana Paula Tagliari Adriano Nunes Kochi Thaís Mariel Andara Beuren Gustavo Chiari Cabral Flávio Vinicius Costa Ferreira Luiz Cláudio Danzmann Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development Brazilian Journal of Cardiovascular Surgery Heart Failure Cardiac Pacing Artificial Cardiomyopathies Ventricular Function Biological Factors. |
| title | Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development |
| title_full | Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development |
| title_fullStr | Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development |
| title_full_unstemmed | Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development |
| title_short | Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development |
| title_sort | cardiomyopathy induced by artificial cardiac pacing to whom when why and how insights on heart failure development |
| topic | Heart Failure Cardiac Pacing Artificial Cardiomyopathies Ventricular Function Biological Factors. |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022005009201&tlng=en |
| work_keys_str_mv | AT andresdileoniferrari cardiomyopathyinducedbyartificialcardiacpacingtowhomwhenwhyandhowinsightsonheartfailuredevelopment AT eduardobartholomayoliveira cardiomyopathyinducedbyartificialcardiacpacingtowhomwhenwhyandhowinsightsonheartfailuredevelopment AT anapaulatagliari cardiomyopathyinducedbyartificialcardiacpacingtowhomwhenwhyandhowinsightsonheartfailuredevelopment AT adrianonuneskochi cardiomyopathyinducedbyartificialcardiacpacingtowhomwhenwhyandhowinsightsonheartfailuredevelopment AT thaismarielandarabeuren cardiomyopathyinducedbyartificialcardiacpacingtowhomwhenwhyandhowinsightsonheartfailuredevelopment AT gustavochiaricabral cardiomyopathyinducedbyartificialcardiacpacingtowhomwhenwhyandhowinsightsonheartfailuredevelopment AT flavioviniciuscostaferreira cardiomyopathyinducedbyartificialcardiacpacingtowhomwhenwhyandhowinsightsonheartfailuredevelopment AT luizclaudiodanzmann cardiomyopathyinducedbyartificialcardiacpacingtowhomwhenwhyandhowinsightsonheartfailuredevelopment |