الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The only effective treatment for persistent irreversible bradycardia is cardiac pacing and it started since more than 5 decades. It was well tolerated and beneficial for the patients. PICM also reported on different articles but with variable incidence depending on variable definitions, methods and substrates.
Multiple studies had been done to assess the validity of GLS for detecting subclinical LV dysfunction, and its role as a predictor of outcome on different cardiac conditions, including the effect of RV pacing on LV function and it seem to be independent predictor according to different studies.
The aim of the study is to determine the validity of speckle tracking echocardiography as a predictor of the deleterious effect of RV pacing on left ventricular function, using 2D guided global and segmental longitudinal strain.
The present study included 50 patients with conventional indications for permanent pacemaker implantation, and at follow-up were divided into 2 groups:
group A: Represent patients who didn’t show significant reduction of EF.
group B: Represent patients who showed significant reduction of EF.
group C: 25 healthy persons (control group).
All the patients and the control included in the research were subjected to:
1. Thorough history taking and clinical examination.
2. Laboratory investigations including measurement of complete blood count, renal function tests, liver function tests, fasting blood sugar.
3. Baseline ECG.
4. Baseline Echocardiography including global and segmental longitudinal strain.
Criteria to enrollment on the study included only patients with Conventional indications for permanent RV Pacing implantation with Ejection fraction is equal or more than 50 %. Criteria of exclusion ruled out patients with baseline Ejection fraction less than 50%, Patients with RV pacing less than 40 % of time on follow up, patients experienced acute coronary syndrome and /or coronary revascularization within 3months before enrollment to 6 months after the enrollment and patients with new onset myocarditis or AF during follow up.
Informed consent was taken from all patients before the beginning of the study.
Follow-up done after 6 months and patients were subjected to history taking, clinical examination, conventional echocardiography and device interrogation.