THE EFFECT OF SINGLE CHAMBER RIGHT VENTRICULAR PACING ON THE CLINICAL PROFILES, QRS MORPHOLOGY AND QRS DURATION

Dr. Lalan Pratap Singh, Dr. Shomu Bohora, Dr. Gajendra Dubey, Dr. Om Prakash Arya, Dr. Pradeep Kurmi*

U. N. Mehta Institute of Cardiology & Research Centre (UNMICRC), Civil Hospital, Ahmedabad, Gujarat, India

ABSTRACT

To assess the impact of single chamber right ventricular pacing on the clinical profiles, QRS morphology and QRS duration on electrocardiogram. This prospective study was conducted to evaluate clinical profile, QRS morphology and QRS duration of patients are having a atrioventricular disease, undergoing single chamber pacemaker implantation between November 2017 to January 2019 at UNMICRC, Ahmedabad, Gujarat. All patients were followed up biannually. At each follow-up visit clinical features were assessed, and pacemaker interrogation, electrocardiography was done. Results: Out of 135 patients, 98 patients completed 12 months follow -up and were included in final analysis. Mean age was 65.92 ± 9.64 years with 60.2% male. Most common comorbidity was hypertension (49.5%) followed by diabetes mellitus type II (24.5%), coronary artery disease (9.2%), hypothyroidism (4.1%) and cerebro vascular accident (2.0%). The Commonest indication for pacemaker was complete heart block (85.7%) followed by high degree Atrioventricular (AV) block (14.3%). 35.7% and 40.8% patients had presyncope and syncope. About 16.3% and 7.1% patients had New York Heart Failure Association (NYHA 2) and (NYHA 3) grade dyspnea. In the present study, baseline QRS was 155.63 ± 15.70 ms which increased to 164.79 ± 10.69 ms at 12 month follow- up (p = 0.0001). All except 4 patients had Left Bundle Branch Block (LBBB) on baseline of electrocardiogram ECG. The QRS duration increases over one year follow- up. The patients remain asymptomatic for heart failure and arrhythmias on follow-up.

Keywords:

COVID-19, QRS, ECG, ventricular, heart disease, pacemaker