Skip to main content
main-content

01.12.2014 | Ausgabe 3/2014

Journal of Interventional Cardiac Electrophysiology 3/2014

Paced QRS axis as a predictor of pacing-induced left ventricular dysfunction

Zeitschrift:
Journal of Interventional Cardiac Electrophysiology > Ausgabe 3/2014
Autoren:
Sung-Hwan Kim, Yong-Seog Oh, Gi-Byoung Nam, Kee-Joon Choi, Jae Seok Park, Sang Weon Park, Seung-Jung Park, Young Keun On, June Soo Kim, Woo-Seung Shin, Ji-Hoon Kim, Sung-Won Jang, Man Young Lee, You-Ho Kim, Tai-Ho Rho

Abstract

Purpose

The selection of the optimal right ventricular (RV) pacing site remains unclear. We hypothesized that a normal paced QRS axis would provide a physiological ventricular activation and lead to a better long-term outcome.

Methods

We evaluated 187 patients who underwent a permanent pacemaker implantation and were dependent on RV pacing. The pacing sites were classified as the apex and non-apex according to the chest radiography. A paced QRS axis was defined as that between −30° and 90°. Preservation of the left ventricular (LV) systolic function was defined as that with a <10 % decrease in the ejection fraction after the pacemaker implantation.

Results

The median follow-up period was 5.8 years (interquartile 3.9–9.0). Radiographically, the RV leads were located in the apex (n = 148, 79 %) or non-apex (n = 39, 21 %). In the electrocardiogram, normal paced and abnormal paced QRS axes were observed in 28 patients (15 %) and 159 patients (85 %), respectively. The LV ejection fraction was decreased in the patients with an abnormal paced QRS axis (−10 ± 10 %, P < 0.001), but not in those with a normal axis (0 ± 6 %, P = 0.80). The electrocardiographic determinant differentiated a preserved LV function (95 % vs. 35 %, log-rank P = 0.04). Among the patients with radiographically non-apical pacing, a normal paced QRS axis was an additional meaningful predictor of a preserved LV function after the pacemaker implantation (95 % vs. 24 %, log-rank P = 0.002).

Conclusion

Compared with the radiographic method, a normal paced QRS axis was associated with a preserved LV function.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 3/2014

Journal of Interventional Cardiac Electrophysiology 3/2014 Zur Ausgabe
  1. Sie können e.Med Innere Medizin 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Kardiologie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Kardiologie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise