الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Right ventricular pacing for the treatment of various conduction disorder, is associated with effects on left ventricular function leading to reduction in the left ventricular ejection fraction and causing pacing induced cardiomyopathy over time. The aim of this work was to study the effects of dual chamber pacemaker on left ventricular function using 2D speckle tracking echocardiography. The study was carried on 53 patients with conduction disturbance who were candidate for dual chamber pacemaker implantation. All patients underwent dual chamber pacemaker implantation and followed up for a period 3 months after implantation. 2D speckle tracking echocardiography was done at baseline and 1 week then 3 months period. Follow up of ejection fraction and global longitudinal strain to detect the effect of RV pacing on LV function. The patients were divided retrograde into three groups according to decline in ejection fraction (non-significant decline, pacemaker induced ventricular dysfunction and pacemaker induced cardiomyopathy). Pacemaker induced ventricular dysfunction (PIVD) was defined as a decline in LVEF by 5 percentage points, while pacemaker induced cardiomyopathy (PICM) was defined as a decline in LVEF to <45%. Our results demonstrated that at 3 months post pacemaker implantation (10) patients developed PIVD; 2 of them developed PICM. At one week follow up, GLS was significantly lower in patients who developed PIVD, compared to those who did not. Speckle tracking echocardiography provides angle-independent accurate measurements of LV strain. Global longitudinal strain at 1 week post pacemaker implantation can predict subsequent decline in LV contractility and ejection fraction, hence can be used to identify patients at risk to develop pacemaker induced ventricular dysfunction or cardiomyopathy.