Assessment of Left Ventricular Asynchrony after Insertion of Dual Chamber Pacemaker by Using Two-Dimensional Speckle Tracking Echocardiography

Abstract

Background: Right ventricular pacing for the treatment of various conduction disorder, is associated with effects on left ventricular function leading to reduction in the left ventricular ejection fraction and causing pacing induced cardiomyopathy over time. Objective: To study the effects of dual chamber pacemaker on left ventricular function using 2D speckle tracking echocardiography. Patients and Methods: The present study was conducted on a cohort of 53 patients with conduction disturbances who underwent dual chamber pacemaker implantation at the Cardiology department of Tanta University Hospital. The study period spanned from December 1, 2021 to May 1,2022. Prior to pacemaker implantation, 2D Speckle tracking echocardiography was performed. Subsequent assessments were conducted at one week and three months intervals post implantation. Results: Our results demonstrated that at 3 months post pacemaker implantation (10) patients developed PIVD; 2 of them developed PICM. At one week follow up, GLS was significantly lower in patients who developed PIVD, compared to those who did not. Speckle tracking echocardiography provides angleindependent
accurate measurements of LV strain. Global longitudinal strain at 1 week post pacemaker implantation can predict subsequent decline in LV contractility and ejection fraction, hence can be used to identify patients at risk to develop pacemaker induced ventricular dysfunction or cardiomyopathy. Conclusion: 2D-speckle tracking can be used as early predictor way for pacemaker induced ventricular dysfunction as well as pacemaker induced cardiomyopathy in patients who went dual chamber pacemaker.