ISSN 2564-7784 | E-ISSN 2564-7040
1 Department of Cardiology, Mustafa Kemal University School of Medicine, Hatay, Turkey  
Eur J Ther ; : -



Objective: Although chronic RV apex pacing is usually well tolerated in patients with normal cardiac function, not only left ventricular systolic function, but also diastolic function have been found to be adversely affected in recent studies. We aimed to detect the relationship between paced QRS, paced QTc duration and echocardiographic parameters of LV diastolic dysfunction to examine the effects of RVA pacing in patients with preserved LV ejection fraction.


Methods: We included 74 patients with LVEF>50% and DDD(R) pacemakers implanted for AV block (45 male, 29 female; mean age 64.9±11.6 years). Patients were included to the study at least 6 months after battery implantation. Patients with RVA pacing rate < %70 were excluded from the study. Patients were classified into two groups according to the LA volume index.


Results: Paced QTc was associated with LA volume index, LA volume, LA end-diastolic diameter, E-wave deceleration time, septal annular e' velocity and mitral E/e’ ratio in bivariate analysis. The cutoff value of pQTc obtained by ROC curve analysis was 512 ms for prediction of increased (>34ml/m2) LA volume index (sensitivity: 88.0%, specificity: 79.6%). The area under the curve (AUC) was 0.848 (p<0.001).


Conclusion: Paced QTc duration was found to be significantly associated with the echocardiographic parameters of LV diastolic dysfunction. We suggest that pQTc may be used as a marker to predict the risk of diastolic dysfunction after permanent pacemaker implantation in patients with preserved LVEF. It can also thought be used to optimize the RV pacing area with intraoperative measurements.

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