Ventricular function and long-term pacing in children with congenital complete atrioventricular block

Jeffrey J. Kim, Richard A. Friedman, Benjamin W. Eidem, Bryan C. Cannon, Gaurav Arora, E. O Brian Smith, Arnold L. Fenrich, Naomi J. Kertesz

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Ventricular Function and Pacing in CCAVB. Objective: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block. Background: Pacing is a well-accepted therapy for patients with congenital complete atrioventricular block. The long-term sequela of right ventricular pacing in this population has not been well described. Methods: We performed a cohort study on all patients with congenital complete atrioventricular block who underwent pacemaker implantation at our institution from 1972 to 2004. Patients with associated congenital heart disease or ventricular dysfunction prior to pacemaker implantation were excluded. Results: A total of 63 patients were included in the study. The median age at pacemaker implantation was 6.5 years, with an average follow-up of 9.9 years. The cumulative dysfunction free survival at 20 years was 92%. In total, four patients (6%) were noted to develop LV dysfunction an average of 15.1 years after pacemaker implantation. Of 30 patients who were paced for >10 years, only three (10%) developed echocardiographic evidence of LV dysfunction. Right ventricular apex pacing and prolonged QRS duration were found to be predictive of decreased long-term LV systolic function (P < 0.05). Conclusions: Left ventricular dysfunction in patients with congenital complete atrioventricular block is a rare finding, even in those who have been paced for more than 10 years. Right ventricular apex pacing and prolonged QRS duration may be associated with decreased ventricular function over time. At this time, with such a low incidence of cardiac dysfunction, right ventricular pacing should be considered an acceptable first-line therapy in this population.

Original languageEnglish (US)
Pages (from-to)373-377
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume18
Issue number4
DOIs
StatePublished - Apr 2007
Externally publishedYes

Fingerprint

Ventricular Function
Atrioventricular Block
Right Ventricular Dysfunction
Ventricular Dysfunction
Left Ventricular Dysfunction
Population
Heart Diseases
Cohort Studies
Survival
Incidence
Therapeutics

Keywords

  • Atrioventricular block
  • Cardiac function
  • Cardiomyopathy
  • Pacing
  • Pediatrics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Ventricular function and long-term pacing in children with congenital complete atrioventricular block. / Kim, Jeffrey J.; Friedman, Richard A.; Eidem, Benjamin W.; Cannon, Bryan C.; Arora, Gaurav; Smith, E. O Brian; Fenrich, Arnold L.; Kertesz, Naomi J.

In: Journal of Cardiovascular Electrophysiology, Vol. 18, No. 4, 04.2007, p. 373-377.

Research output: Contribution to journalArticle

Kim, Jeffrey J. ; Friedman, Richard A. ; Eidem, Benjamin W. ; Cannon, Bryan C. ; Arora, Gaurav ; Smith, E. O Brian ; Fenrich, Arnold L. ; Kertesz, Naomi J. / Ventricular function and long-term pacing in children with congenital complete atrioventricular block. In: Journal of Cardiovascular Electrophysiology. 2007 ; Vol. 18, No. 4. pp. 373-377.
@article{7796c51512b84491b693c5af3fea684a,
title = "Ventricular function and long-term pacing in children with congenital complete atrioventricular block",
abstract = "Ventricular Function and Pacing in CCAVB. Objective: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block. Background: Pacing is a well-accepted therapy for patients with congenital complete atrioventricular block. The long-term sequela of right ventricular pacing in this population has not been well described. Methods: We performed a cohort study on all patients with congenital complete atrioventricular block who underwent pacemaker implantation at our institution from 1972 to 2004. Patients with associated congenital heart disease or ventricular dysfunction prior to pacemaker implantation were excluded. Results: A total of 63 patients were included in the study. The median age at pacemaker implantation was 6.5 years, with an average follow-up of 9.9 years. The cumulative dysfunction free survival at 20 years was 92{\%}. In total, four patients (6{\%}) were noted to develop LV dysfunction an average of 15.1 years after pacemaker implantation. Of 30 patients who were paced for >10 years, only three (10{\%}) developed echocardiographic evidence of LV dysfunction. Right ventricular apex pacing and prolonged QRS duration were found to be predictive of decreased long-term LV systolic function (P < 0.05). Conclusions: Left ventricular dysfunction in patients with congenital complete atrioventricular block is a rare finding, even in those who have been paced for more than 10 years. Right ventricular apex pacing and prolonged QRS duration may be associated with decreased ventricular function over time. At this time, with such a low incidence of cardiac dysfunction, right ventricular pacing should be considered an acceptable first-line therapy in this population.",
keywords = "Atrioventricular block, Cardiac function, Cardiomyopathy, Pacing, Pediatrics",
author = "Kim, {Jeffrey J.} and Friedman, {Richard A.} and Eidem, {Benjamin W.} and Cannon, {Bryan C.} and Gaurav Arora and Smith, {E. O Brian} and Fenrich, {Arnold L.} and Kertesz, {Naomi J.}",
year = "2007",
month = "4",
doi = "10.1111/j.1540-8167.2006.00741.x",
language = "English (US)",
volume = "18",
pages = "373--377",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Ventricular function and long-term pacing in children with congenital complete atrioventricular block

AU - Kim, Jeffrey J.

AU - Friedman, Richard A.

AU - Eidem, Benjamin W.

AU - Cannon, Bryan C.

AU - Arora, Gaurav

AU - Smith, E. O Brian

AU - Fenrich, Arnold L.

AU - Kertesz, Naomi J.

PY - 2007/4

Y1 - 2007/4

N2 - Ventricular Function and Pacing in CCAVB. Objective: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block. Background: Pacing is a well-accepted therapy for patients with congenital complete atrioventricular block. The long-term sequela of right ventricular pacing in this population has not been well described. Methods: We performed a cohort study on all patients with congenital complete atrioventricular block who underwent pacemaker implantation at our institution from 1972 to 2004. Patients with associated congenital heart disease or ventricular dysfunction prior to pacemaker implantation were excluded. Results: A total of 63 patients were included in the study. The median age at pacemaker implantation was 6.5 years, with an average follow-up of 9.9 years. The cumulative dysfunction free survival at 20 years was 92%. In total, four patients (6%) were noted to develop LV dysfunction an average of 15.1 years after pacemaker implantation. Of 30 patients who were paced for >10 years, only three (10%) developed echocardiographic evidence of LV dysfunction. Right ventricular apex pacing and prolonged QRS duration were found to be predictive of decreased long-term LV systolic function (P < 0.05). Conclusions: Left ventricular dysfunction in patients with congenital complete atrioventricular block is a rare finding, even in those who have been paced for more than 10 years. Right ventricular apex pacing and prolonged QRS duration may be associated with decreased ventricular function over time. At this time, with such a low incidence of cardiac dysfunction, right ventricular pacing should be considered an acceptable first-line therapy in this population.

AB - Ventricular Function and Pacing in CCAVB. Objective: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block. Background: Pacing is a well-accepted therapy for patients with congenital complete atrioventricular block. The long-term sequela of right ventricular pacing in this population has not been well described. Methods: We performed a cohort study on all patients with congenital complete atrioventricular block who underwent pacemaker implantation at our institution from 1972 to 2004. Patients with associated congenital heart disease or ventricular dysfunction prior to pacemaker implantation were excluded. Results: A total of 63 patients were included in the study. The median age at pacemaker implantation was 6.5 years, with an average follow-up of 9.9 years. The cumulative dysfunction free survival at 20 years was 92%. In total, four patients (6%) were noted to develop LV dysfunction an average of 15.1 years after pacemaker implantation. Of 30 patients who were paced for >10 years, only three (10%) developed echocardiographic evidence of LV dysfunction. Right ventricular apex pacing and prolonged QRS duration were found to be predictive of decreased long-term LV systolic function (P < 0.05). Conclusions: Left ventricular dysfunction in patients with congenital complete atrioventricular block is a rare finding, even in those who have been paced for more than 10 years. Right ventricular apex pacing and prolonged QRS duration may be associated with decreased ventricular function over time. At this time, with such a low incidence of cardiac dysfunction, right ventricular pacing should be considered an acceptable first-line therapy in this population.

KW - Atrioventricular block

KW - Cardiac function

KW - Cardiomyopathy

KW - Pacing

KW - Pediatrics

UR - http://www.scopus.com/inward/record.url?scp=33947211956&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33947211956&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8167.2006.00741.x

DO - 10.1111/j.1540-8167.2006.00741.x

M3 - Article

C2 - 17394451

AN - SCOPUS:33947211956

VL - 18

SP - 373

EP - 377

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 4

ER -