Pengaruh Implantasi Alat Pacu Jantung Permanen terhadap Nilai Fraksi Ejeksi Ventrikel Kiri Pasien di RSUP Haji Adam Malik Medan

Abstract

Background: Permanent pacemaker (PPM) implantation in symptomatic bradycardia aims to restore abnormal heart rhythm. However, several studies have shown there was a decline in left ventricle ejection fraction following the permanent pacemaker implantation pacemaker that could caused pacing induced cardiomyopathy . The purpose of this study is to assess the effect of permanent pacemaker implantation on the value of the left ventricular ejection fraction (LVEF). Method: This cohort study included 52 patients undergoing permanent pacemaker implantation in Haji Adam Malik General Hospital from January 2021 until July 2022. The LVEF calculated by echocardiography examination using biplane simpson method three times; before permanent pacemaker implantation, 6-12 months, and >12 months after PPM implantation. Results: In median 15,5 months, the LVEF decreased significantly in right ventricle apex pacing group (58% to 49%) and midseptum right ventricle pacing group (58,3% to 51,4% ; p < 0,001). Coronary heart disease (p=0,007), ventricular pacing > 80% (p=0,047), paced QRS duration (p=0,011), and baseline LVEF (p<0,001) significantly corelated with PIC. Conclusion: The LVEF significantly decreased in right ventricle apex and midseptum pacing. Coronary heart disease, lower baseline LVEF, ventricular pacing > 80%, paced QRS duration > 150ms were simultaneously contribute to PIC.