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  • Title: Electrocardiographic alterations after chronic right ventricular apical pacing in patients with sinus node dysfunction.
    Author: Ding LG, Hua W, Chu JM, Liu XB, Wang J, Niu HX, Chen KP, Zhang S.
    Journal: J Electrocardiol; 2009; 42(3):276-80. PubMed ID: 19159904.
    Abstract:
    OBJECTIVE: The purpose of this study is to investigate the potential to induce electrical remodeling by chronic right ventricular apical (RVA) in patients with sinus node dysfunction. METHODS: Ninety-two patients with sinus node dysfunction who underwent initial pacemaker implantation were included in the study. During routine clinic visits, electrocardiograms and echocardiograms were recorded. Forty-five patients were also studied as controls. RESULTS: During a mean follow-up time of 3.3 +/- 0.5 years, the intrinsic QRS duration increased from 87 +/- 9 milliseconds before device implantation to 94 +/- 10 milliseconds (P < .001). The left ventricular end-diastolic diameter increased from 46 +/- 3 to 50 +/- 4 mm (P < .001), and the left ventricular ejection fraction decreased from 63% +/- 4% to 57% +/- 5% (P < .001). Logistic regression analysis revealed that elderly age at the time of pacemaker implantation (odds ratio [OR], 3.41; 95% confidence interval [CI], 1.07-10.90; P = .04), RVA pacing (OR, 3.91; 95% CI, 1.10-13.89; P = .03), and coronary artery disease (OR, 7.33; 95% CI, 1.09-50.29; P = .04) were independent predictors of the prolongation of intrinsic QRS duration. CONCLUSIONS: The present study indicated that chronic RVA pacing may lead to a prolongation of intrinsic QRS duration, which could be independently predicted by elderly age, chronic RVA pacing, and the presence of coronary artery disease.
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