Impact of single chamber and dual chamber permanent pacemaker implantation on left ventricular function: An observational study

Background: Permanent pacemaker implantation has the potential to impact left ventricular (LV) function and hence quality of life (QoL) in the long term.

Aim: To assess the effect of single- and dual-chamber pacing on LV function and QoL.

Methods: This study included 56 patients who underwent permanent pacing: Dual pacing, dual sensing, dual responsive and rate responsive (DDDR) for the initial 3 months and ventricular pacing, ventricular sensing, inhibited response and rate responsive (VVIR) for the next 3 months, and DDDR mode for the last 3 months. Throughout the study period, various echocardiographic parameters, functional status, and QoL were measured to assess the impact of pacing on LV function compared with baseline and at every 3 months interval.

Results: A significant change appeared in cardiac function after VVIR pacing which included diastolic properties of LV as shown by increase in isovolumic relaxation time from (85.28 ± 9.54 ms) to (89.53 ± 9.65 ms). At the 3-, 6-, and 9-month follow-up, reduction in LV ejection fraction was observed to be 62.71 ± 4.66%, 61.07 ± 4.41%, and 58.48 ± 3.89%, respectively. An increase in the QoL scores was noted at every follow-up visit.

Conclusion: An apparent depressant effect on LV function due to right ventricular pacing, with a higher incidence of adverse outcomes in the VVIR mode. In addition, an upsurge in QoL scores for the study population was noted, which indicates improvement in the QoL of patients post-pacing, irrespective of the mode. Generally, the DDDR mode is a highly preferable pacing mode.