Why is pacemaker-induced cardiomyopathy so fascinating?

Author(s): Christoph Melzer

Today Cardiac Resynchronization Therapy (CRT) upgrade is the therapy of choice for Pacemaker-Induced Cardiomyopathy (PICM). Melzer et al., recently published the largest prospective study revealing the effectiveness of a CRT upgrade in patients suffering from PICM in an outpatient clinic. 55 patients received a CRT upgrade. 43.6% of patients were > 80 years (83.4 + 2.9 years). For the primary endpoint, Left Ventricular End Systolic Volume (LVESV) decreased from 101.6 + 48.2 ml to 75.9 + 35.8 ml (p< 0.001). For the secondary endpoints, LVEF increased from 31.5 + 5.4 % to 46.1 + 7.6 % (p < 0.001) the responder rate was 83.6%. The study shows, for the first time, that older patients (>80 years) benefit from upgrading CRT to the same extent as younger patients. In conclusion there are no reasonable arguments against the CRT upgrade in patients with PICM