Relationship between right ventricular pacing and non-sustained ventricular arrhythmias in patients with dual-chamber pa
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ternational Journal of Arrhythmia Open Access
RESEARCH
Relationship between right ventricular pacing and non‑sustained ventricular arrhythmias in patients with dual‑chamber pacemaker and normal range left ventricular ejection fraction Rayan S. El‑Zein1, Anish K. Amin2, Sreedhar R. Billakanty2, Eugene Y. Fu2, Allan J. Nichols2, Steven D. Nelson2, James M. Kleman2, Gregory A. Kidwell2 and Nagesh Chopra2*
Abstract Background: Right ventricular pacing (RVP) increases heart failure, AF, and death rates in pacemaker patients and ventricular arrhythmias (VAs) in defibrillator patients. However, the impact of RVP on VAs burden and its clinical sig‑ nificance in pacemaker patients with normal range LVEF of > 50–55% remains unknown. We sought to evaluate the relationship of RVP and VAs and its clinical impact in a pacemaker patient population. Methods: Records of 105 patients who underwent de novo dual-chamber pacemaker implant or a generator change (Medtronic™ or Boston Scientific™) for AV block and sinus node disease at a tertiary care center between September 1, 2015, and September 1, 2016, were retrospectively reviewed. Results: Data from 105 patients (51% females, mean age 76 ± 1 years, mean LVEF 61 ± 0.7%) without history of VAs (98.2%) were reviewed over 1044 ± 23 days. Dependent patients (100% RVP) exhibited the lowest VAs burden when compared to 50–55% and no apparent arrhythmogenic substrate, the impact of RVP on the incidence of nuisance non-sustained ventricular arrhythmias (NNVAs) such as isolated premature ventricular contraction (PVCs), PVC runs of 2–4 beats (PVC runs), and non-sustained ventricular tachycardia of > 4 beats but lasting 18 years. 2. Baseline LVEF of > 50–55%. 3. New permanent dual-chamber pacemaker (PPM) implant or a generator change of an existing dualchamber pacemaker. 4. Pacemaker manufacturer, Medtronic™ or Boston Scientific™ only. 5. Diagnosis of AV block or SAND for PPM implant. 6. Pacemaker implants performed only at a tertiary care medical center (Riverside Methodist Hospital, Columbus, Ohio, USA). 7. Procedure performed between September 1, 2015, and September 1, 2016. Study exclusion criteria included: 1. Single-chamber pacemaker implants or generator change. 2. Post-procedure follow-up of
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