MIDTERM EFFECTS OF PERMANENT ENDOCARDIAL VENTRICULAR PACING ON CARDIAC STRUCTURAL AND GEOMETRIC PARAMETERS IN ATRIOVENTRICULAR BLOCK

Gaulika Stanislav Olegovich, Molchanov Andrey Nikolaevich, Morgunov Denis Pavlovich

This comparative retrospective study analyzed cardiac structural and geometric parameters 24 months post-implantation in patients with atrioventricular conduction disorders. Despite baseline similarity between groups, the IVS pacing group demonstrated statistically significant advantages in the mid- to long-term period: Interventricular septum thickness remained stable in the IVS group but increased by 21% in the apical pacing group. Right atrial size was 15% smaller in the IVS group. Left atrial dimensions were 22% smaller in the IVS group. Left ventricular ejection fraction (LVEF) was 5% higher in the IVS group.End-diastolic volume (EDV) and end-diastolic dimension (EDD) increased in both groups at 24 months, but the IVS group showed smaller increments (+11% EDV, +12% EDD vs. +18% EDV, +22% EDD in the apical group). IVS pacing is associated with preserved cardiac geometry, reduced atrial remodeling, and better LV systolic function compared to traditional apical pacing in patients with atrioventricular block.

Keywords:cardiac electrophysiology, hemodynamics, ventricular remodeling, pacing-induced cardiomyopathy