Cardiomyopathy Induced by Artificial Cardiac Pacing: To Whom, When, Why, and How? Insights on Heart Failure Development

Coordinated and harmonic (synchronous) ventricular electrical activation is essential for better left ventricular systolic function. Intraventricular conduction abnormalities, such as left bundle branch block due to artificial cardiac pacing, lead to electromechanical "dyssynchronopathy" w...

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Vydáno v:Revista brasileira de cirurgia cardiovascular Ročník 38; číslo 2; s. 278 - 288
Hlavní autoři: Ferrari, Andres Di Leoni, Oliveira, Eduardo Bartholomay, Tagliari, Ana Paula, Kochi, Adriano Nunes, Beuren, Thaís Mariel Andara, Cabral, Gustavo Chiari, Ferreira, Flávio Vinicius Costa, Danzmann, Luiz Cláudio
Médium: Journal Article
Jazyk:angličtina
Vydáno: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01.01.2023
Témata:
Arrhythmias, Cardiac
Artificial
Biological Factors
CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiac arrhythmia
Cardiac Pacing
Cardiac Pacing, Artificial - adverse effects
Cardiology
Cardiomyopathies
Cardiomyopathies - etiology
Cardiomyopathies - therapy
Cardiomyopathy
Cardiovascular disease
Coronary vessels
Ejection fraction
Heart Failure
Heart Failure - etiology
Heart Failure - therapy
Heart surgery
Humans
Pacemakers
Pathophysiology
Physiology
Review
SURGERY
Ultrasonic imaging
Vein & artery diseases
Ventricular Function
Ventricular Function, Left
Artificial
Cardiac Pacing
Heart Failure
Biological Factors
Cardiomyopathies
Ventricular Function
ISSN:1678-9741, 0102-7638, 1678-9741
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Shrnutí:Coordinated and harmonic (synchronous) ventricular electrical activation is essential for better left ventricular systolic function. Intraventricular conduction abnormalities, such as left bundle branch block due to artificial cardiac pacing, lead to electromechanical "dyssynchronopathy" with deleterious structural and clinical consequences. The aim of this review was to describe and improve the understanding of all the processes connecting the several mechanisms involved in the development of artificially induced ventricular dyssynchrony by cardiac pacing, most known as pacing-induced cardiomyopathy (PiCM). The chronic effect of abnormal impulse conduction and nonphysiological ectopic activation by artificial cardiac pacing is suspected to affect metabolism and myocardial perfusion, triggering regional differences in the activation/contraction processes that cause electrical and structural remodeling due to damage, inflammation, and fibrosis of the cardiac tissue. The effect of artificial cardiac pacing on ventricular function and structure can be multifactorial, and biological factors underlying PiCM could affect the time and probability of developing the condition. PiCM has not been included in the traditional classification of cardiomyopathies, which can hinder detection. This article reviews the available evidence for pacing-induced cardiovascular disease, the current understanding of its pathophysiology, and reinforces the adverse effects of right ventricular pacing, especially right ventricular pacing burden (commonly measured in percentage) and its repercussion on ventricular contraction (reflected by the impact on left ventricular systolic function). These effects might be the main defining criteria and determining mechanisms of the pathophysiology and the clinical repercussion seen on patients.
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ISSN:1678-9741
0102-7638
1678-9741
DOI:10.21470/1678-9741-2021-0629