The effect of different pacing modes on LV global and regional
longitudinal systolic strain by 2-D speckle tracking echocardiography
Abstract
Background Inspite of the fact that the life quality improved for most
patients with a cardiac pacemaker implant, the pacing induced left
bundle branch block pattern can result in changes of the structure,
function and hemodynamic of the heart. Methods: This study was performed
on 30 patients with history of dual chamber pacemaker implantation more
than 6 months duration and 30 healthy volunteers as controls.
Conventional and 2-D speckle tracking echocardiography were performed to
evaluate the LV global and regional systolic longitudinal strain in
different pacing modes. Results: Pacemaker programming from atrial
sensed-ventricular paced mode (AS-VP mode) to atrial paced-ventricular
paced mode (AP-VP) showed a significant decrease in global LV
longitudinal systolic strain (P value <0.05). Moreover,
programming to asynchronous ventricular pacing (VVI mode) demonstrated a
further significant reduction of global LV LSS when compared to other
pacing modes (P value <0.05). Conclusion: Permanent RV apical
pacing leads to marked changes of LV systolic function. Moreover, atrial
pacing and asynchronous ventricular pacing may cause more deterioration
of LV global and regional systolic longitudinal strain detected by 2-D
speckle tracking echocardiography.