Quality of life and functional capacity after long-term right ventricular pacing in pediatrics and young adults with congenital atrioventricular block.

BACKGROUND: Although several studies have demonstrated deleterious consequences of chronic right ventricular (RV) pacing on ventricular function and synchronicity, its effects on health-related quality of life (HRQoL) and functional exercise capacity remain uncertain. We aimed to evaluate the effect of RV pacing on HRQoL and functional capacity of children and young adults with congenital complete atrioventricular block (CCAVB). METHODS: We included 66 consecutive subjects with RV cardiac pacemaker due to CCAVB and under clinical follow-up for more than 1 year. Multidimensional HRQoL scores were evaluated by Short Form-36 Health Survey (SF-36) and Child Health Questionnaire-Parent Form 50 (CHQ-PF50). Functional capacity was tested by a 6-minute walk distance test (6MWDT). Association analysis was performed to examine if any demographic and clinical characteristics were associated with lower HRQoL scores and shorter distances at the 6MWDT. RESULTS: Domains presenting lower HRQoL scores were vitality (64.0 ± 17.3), mental health (67.3 ± 8.0), role emotional (69.7 ± 35.8) in the SF-36 questionnaire; general health perceptions (61.3 ± 8.3), general behavior (61.9 ± 15.6), parental impact-emotional (67.7 ± 28.7) in the CHQ-PF50. Female gender (P = 0.009), left ventricular ejection fraction lower than 55% (P = 0.013), cardiovascular drugs (P = 0.003) were significantly associated with lower HRQoL scores. Average distance traveled during the 6MWDT was 539.8 ± 82.9 m. The 6MWDT showed significant association with age (P = 0.006) and cardiovascular drugs (P = 0.024). CONCLUSIONS: Chronic RV pacing did not affect the HRQoL and physical capacity of pediatrics and young subjects. Female gender, ventricular function, and cardiovascular drugs were associated with lower HRQoL scores. Older subjects walked shorter distances in the 6MWDT, as well as subjects who were taking cardiovascular drugs.

Changes in the mental and physical components of the quality of life for patients six months after pacemaker implantation.

BACKGROUND: The additional purpose for pacemaker implantation, beyond treating arrhythmias and conduction disturbances, is to improve the quality of life (QoL) of the patient. Most previous research has shown this purpose to have been achieved. However, the question as to whether all mental and physical components improve QoL to the same degree is still valid. The purpose of this study is to evaluate changes in the primary mental and physical areas of QoL in patients six months after they have had a pacemaker implanted. METHODS: Ninety eight patients with atrioventricular blocks (AVB) and 100 patients with sinus node dysfunction (SND) who were qualified for pacemaker implantation were included in this study. Every patient had a DDD(R)-type pacemaker with bipolar screw-in leads implanted. The ventricular lead was positioned in the right ventricular outflow tract. QoL was evaluated twice: three to five days before implantation and six months afterwards - the MLWHF questionnaire was used. RESULTS: A very high statistical improvement in QoL (p approximately 0,0000) - reduced number of points was found in all five areas of QoL in patients with SND and in four areas in patients with AVB. In the 'anxiety/depression area' in patients with AVB, the average number of points was higher (p = 0.3871), so QoL was worse. CONCLUSIONS: Implanting a pacemaker improves QoL in patients with AVB and SND. In patients with AVB, anxiety/depression is made more intense.