Influence of Right Ventricular Pacing on Right Ventricular Systolic Function

Objectives: To inquire, whether right ventricular (RV) pacing worsens the systolic function of the right ventricle (RV) and, if need be, which position of the RV pacing lead is more favourable with regard to the RV systolic function. To test the ability of the 3D transthoracic echocardiography (TTE), to verify the position of the pacing lead Methods: 37 patients were included in the study in the period since March 2013 to March 2016. This sample was divided in to two groups: with apical and septal position of the lead. For evaluation of the systolic function of the right ventricle we have used tricuspid annulus plain systolic excursions (TAPSE) and tricuspid annulus systolic velocity (TASV) parameters. For statistical analysis we have used pair t-test. We have also studied the influence of the lead position on the difference between the first and the second measurement: We have used non-parametrical Mann-Whitney test. Results: Pair test showed that there is not a significant decrease or increase of the values of both parameters in patients with RV pacing from any site. Non-parametrical Mann-Whitney test suggests that the lead position does not influence the differences between first and second measurements in the given two groups. There was not a single patient, in whom there would be a decline of any studied parameter under the limit of normal values. In all patients, it was possible to display the ventricular lead with the use of transthoracic echo. 3D-TTE often provides better image of the pacing lead and it’s insertion in to the myocardium than 2D-TTE. Conclusion: Our data suggest that RV pacing does not influence the RV systolic function. At the same time we could confirm, that 3D-TTE is a very good and possibly preferable method for verification of the ventricular lead position by its direct visualization unless the image quality is poor.