Assessment of BNP level in patients with single chamber and Dual chamber pacemakers

ABSTRACT

Recent years, have witnessed extended and continuous indication of cardiac pacing. However, increasing number of patients suffered new congestive heart failure [CHF] and aggravated CHF after pacing therapy. We used blood B type nutriuretic peptide [BNP] to predict the occurrence of CHF in patients with different types of pacemakers. To assess single N-terminal brain nutriuretic peptide [NT-pro BNP] as a predictor tool for ventricular dysfunction in different cardiac pacing mode. Out of 480 consecutive patients with pacemaker more than 6 months, 79 patients with average age of 65 +/- 13, and more than 90% ventricular pacing participated in the present study. Those with CHF prior to pacemaker insertion were excluded. The patients underwent medical history and examination, echocardiography [M-mode, Doppler, and Tissue imaging] and blood sampling for pro-BNP. Twenty five, 12, and 42 patients had Dual chamber [DDDR], single chamber pacing with dual chamber sensing [VDDR], and Single chamber [VVIR] pacemakers respectively Single pro-BNP level in patient with DDDR and VDDR pacing was lower than in those with VVIR pacing [P< 0.0001] but in Echocardiography left ventricular [LV] dysfunction was not lower in DDDR than VDDR and VVIR pacing patients [P= 0.190]. Single level of pro-BNP is lower in double chamber pacing in comparison with single chamber pacing. Therefore, it seems that dual chamber pacing causes less LV dysfunction