LV Dysfunction Following Pacemaker Placement
| Status: | Completed |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 2/27/2019 |
| Start Date: | September 2013 |
| End Date: | September 2018 |
The Incidence of Left Ventricular Dysfunction Following Pacemaker Placement: Differential Effects of Intrinsic AV Node Disease v. AV Node Ablation.
Several studies have confirmed the link between chronic RV apical pacing and the development
of heart failure and LV systolic dysfunction in some patients 1,2. However, questions
continue to remain unanswered in regard to the adverse effects of RV pacing such as the exact
amount of RV pacing that is detrimental to cardiac function and which subsets of patients are
most at risk for developing cardiac dysfunction from chronic RV pacing. Rates of permanent
pacemaker implantation have been increased over the last twenty years with expanding
indications to include permanent pacing after AV node ablation for the treatment of drug
refractory atrial fibrillation and other atrial tachy-arrhythmias. The current standard of
practice is to minimize RV pacing however in patients that have had an AV node ablation right
ventricular pacing cannot be avoided therefore it is important to identify if this particular
group of patients is at an increased risk for developing worsening cardiac function. The
purpose of this study is to compare cardiac function over time between patients that have
undergone AV node ablation versus patients that have had pacemaker implantation for AV node
dysfunction.
of heart failure and LV systolic dysfunction in some patients 1,2. However, questions
continue to remain unanswered in regard to the adverse effects of RV pacing such as the exact
amount of RV pacing that is detrimental to cardiac function and which subsets of patients are
most at risk for developing cardiac dysfunction from chronic RV pacing. Rates of permanent
pacemaker implantation have been increased over the last twenty years with expanding
indications to include permanent pacing after AV node ablation for the treatment of drug
refractory atrial fibrillation and other atrial tachy-arrhythmias. The current standard of
practice is to minimize RV pacing however in patients that have had an AV node ablation right
ventricular pacing cannot be avoided therefore it is important to identify if this particular
group of patients is at an increased risk for developing worsening cardiac function. The
purpose of this study is to compare cardiac function over time between patients that have
undergone AV node ablation versus patients that have had pacemaker implantation for AV node
dysfunction.
Study Design This is a retrospective chart review of patients that have undergone permanent
pacemaker implantation by the electrophysiology group at Oregon Health and Sciences
University Hospital during the period between 01/2003 and 01/2013 for chronic RV pacing after
AV node ablation or for AV node dysfunction.
Goal The goal of this study is to determine if patients requiring RV pacing after AV nodal
ablation are at increased risk for developing worsening cardiac function secondary to chronic
RV pacing compared to patients requiring RV pacing for AV node dysfunction.
Specific Objectives
- To determine the number of patients that have a permanent pacemaker implanted after AV
node ablation and for AV node dysfunction within the last 10 years at OHSU Hospital.
- To determine the number of patients that have a biventricular pacemaker implanted with
or without an implantable cardiac defibrillator within the last 10 years at OHSU
Hospital (control group).
- Amongst those patients identified determine (1) left ventricular ejection fraction prior
to permanent pacemaker or biventricular pacemaker implantation and over time (2) left
ventricular volume and/or diameter prior to permanent pacemaker placement and over time
(3) all cause mortality
- Amongst those patients identified determine incidence of new onset atrial fibrillation
after permanent pacemaker or biventricular pacemaker implantation
- Amongst those patients identified determine incidence of inpatient admission of heart
failure exacerbation defined as presenting symptoms of dyspnea, orthopnea, paroxysmal
nocturnal dyspnea, increased lower extremity edema requiring IV diuretics
Methods
This is a retrospective chart review of patients that have undergone permanent pacemaker
medical record system used at OHSU Hospital) with the help of an EPIC representative. If the
patient was referred for permanent pacemaker or biventricular pacemaker implantation from a
physician or medical group outside of OHSU records will be requested from that physician or
medical group.
pacemaker implantation by the electrophysiology group at Oregon Health and Sciences
University Hospital during the period between 01/2003 and 01/2013 for chronic RV pacing after
AV node ablation or for AV node dysfunction.
Goal The goal of this study is to determine if patients requiring RV pacing after AV nodal
ablation are at increased risk for developing worsening cardiac function secondary to chronic
RV pacing compared to patients requiring RV pacing for AV node dysfunction.
Specific Objectives
- To determine the number of patients that have a permanent pacemaker implanted after AV
node ablation and for AV node dysfunction within the last 10 years at OHSU Hospital.
- To determine the number of patients that have a biventricular pacemaker implanted with
or without an implantable cardiac defibrillator within the last 10 years at OHSU
Hospital (control group).
- Amongst those patients identified determine (1) left ventricular ejection fraction prior
to permanent pacemaker or biventricular pacemaker implantation and over time (2) left
ventricular volume and/or diameter prior to permanent pacemaker placement and over time
(3) all cause mortality
- Amongst those patients identified determine incidence of new onset atrial fibrillation
after permanent pacemaker or biventricular pacemaker implantation
- Amongst those patients identified determine incidence of inpatient admission of heart
failure exacerbation defined as presenting symptoms of dyspnea, orthopnea, paroxysmal
nocturnal dyspnea, increased lower extremity edema requiring IV diuretics
Methods
This is a retrospective chart review of patients that have undergone permanent pacemaker
medical record system used at OHSU Hospital) with the help of an EPIC representative. If the
patient was referred for permanent pacemaker or biventricular pacemaker implantation from a
physician or medical group outside of OHSU records will be requested from that physician or
medical group.
Inclusion Criteria: Patients who have undergone permanent pacemaker placement for AV node
dysfunction.
Exclusion Criteria: retrospective--n/a
We found this trial at
1
site
3181 Southwest Sam Jackson Park Road
Portland, Oregon 97239
Portland, Oregon 97239
503 494-8311
Oregon Health and Science University In 1887, the inaugural class of the University of Oregon...
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