Three-Dimensional Systolic Dyssynchrony Index in Real-Time as a Predictor of Pacing-Related Left Ventricular Dysfunction and Cardiomyopathy - Report - MDSpire

Three-Dimensional Systolic Dyssynchrony Index in Real-Time as a Predictor of Pacing-Related Left Ventricular Dysfunction and Cardiomyopathy

  • By

  • Moustafa Dawood

  • Hoda Abdelgawad

  • Aly Aboelhoda

  • Moataz Zaki

  • April 27, 2026

  • 0 min

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Clinical Report: Three-Dimensional Systolic Dyssynchrony Index as a Predictor

Overview

This study evaluates the incidence of pacing-induced ventricular dysfunction (PIVD) and pacing-induced cardiomyopathy (PICM) in patients with high right ventricular pacing. It also investigates the predictive value of the real-time three-dimensional systolic dyssynchrony index (SDI) for subsequent development of significant left ventricular dysfunction.

Background

Chronic right ventricular pacing can lead to left ventricular dysfunction due to mechanical dyssynchrony, which may progress to heart failure. Identifying patients at risk for pacing-induced dysfunction is crucial for timely intervention. The study explores the utility of the SDI as a potential early marker for predicting these adverse outcomes.

Data Highlights

MeasureIncidence
PIVD30-40% in high-risk cohorts
PICM10-15% of patients

Key Findings

  • The study included 60 patients with preserved baseline LVEF (≥ 50%).
  • Pacing-induced ventricular dysfunction (PIVD) was observed in a significant proportion of patients.
  • The systolic dyssynchrony index (SDI) was calculated using real-time three-dimensional echocardiography.
  • Higher SDI values correlated with the development of significant left ventricular dysfunction.
  • Traditional risk factors were insufficient for accurate prediction of pacing-induced dysfunction.

Clinical Implications

Clinicians should consider the use of the SDI as a tool for early identification of patients at risk for pacing-induced left ventricular dysfunction. This may allow for timely interventions to mitigate the risk of progression to heart failure.

Conclusion

The real-time three-dimensional systolic dyssynchrony index is a promising predictor of pacing-related left ventricular dysfunction and cardiomyopathy, highlighting the need for improved risk stratification in patients undergoing RV pacing.

References

  1. Clinical Research in Cardiology, 2026 -- Real-time three-dimensional systolic dyssynchrony index predicts pacing-induced left ventricular dysfunction and cardiomyopathy
  2. Clinical Research in Cardiology — Evaluation of Atrial Conduit Function: Introducing a Novel Index for Diastolic Dysfunction Assessment
  3. European Radiology — Validation of 4D Flow MRI for Assessing Grading of Left Ventricular Diastolic Dysfunction Compared to Echocardiography
  4. Pediatric Cardiology — Cardiac Dysfunction in Pediatric Patients with End-Stage Renal Disease
  5. Clinical Research in Cardiology — Link Between Left Atrial Phasic Conduit Function and Early Recurrence of Atrial Fibrillation Post-Electrical Cardioversion
  6. 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing
  7. Biventricular Pacing for Atrioventricular Block and Systolic Dysfunction (BLOCK-HF)
  8. Real-time three-dimensional systolic dyssynchrony index predicts pacing-induced left ventricular dysfunction and cardiomyopathy | Clinical Research in Cardiology | Springer Nature Link

Original Source(s)

Three-Dimensional Systolic Dyssynchrony Index in Real-Time as a Predictor of Pacing-Related Left Ventricular Dysfunction and Cardiomyopathy

  • by Moustafa Dawood, Hoda Abdelgawad, Aly Aboelhoda, Moataz Zaki

  • April 27, 2026

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