Worsening Left Ventricular Apical Peak Strain Early After Right Ventricular Pacing

We aimed to determine the effect of short-term right ventricle pacing (RV) on left ventricle (LV) mechanics using speckle tracking analysis. Conventional echocardiography and two-dimensional strain imaging was studied in 38 patients, mean age 81.6 ± 7.0, that had undergone pacemaker placement and were greater than 90% ventricularly paced. Mean duration of 24 months of RV pacing resulted in a significant decline in: LV apical diastolic rotational velocities (-59.0 ± -38.9 °/s to -28.0 ± -11.5 °/s, p 0.02), peak strain in the LV apical septal wall (-15.6 ± 8.5 to -13.5 ± 7.6, p 0.02), peak strain in LV apical lateral wall (-13.4 ± 8.9 to -11.4 ± 7.3, p 0.02). Thus, with only 24 months of RV pacing, there was a significant decline in peak strain of the LV apex and in apical diastolic rotational velocity that could account for eventual decline in left ventricular function.