الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
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Abstract
Background: Although the fact that ventricular pacing is highly beneficial in the treatment of various types of symptomatic bradycardia, RVA pacing has harmful effects on both LV diastolic and systolic parameters of both conventional & Tissue Doppler echocardiography.Patients &Methods: This study was conducted on 120 patients who were scheduled for permanent cardiac pacing (73 Single Chamber VVI & 47 Dual Chamber DDD pacing) in order to assess ventricular function by conventional echocardiography & Pulsed tissue Doppler echocardiography after pacemaker implantation of both groups within 1,3 & 6 months. We assess systolic parameters (EF, FS &S’), diastolic parameters (E, A, E/A ratio, E deceleration by pulsed MV flow, E’, A’& E/E’ of septal &lateral MV annulus) & Tie index (LVMPI &RVMPI) as parameter for systolic & diastolic performance of both ventricles.Results: As regards LV systolic function; highly significant decline of EF/FS of both groups (P <0.001),highly significant decrease of S’ of VVI group with less significant decrease with DDD(P 0.002 for lateral MV annulus & 0.011 for septal MV annulus) .As regards LV diastolic function: highly significant decrease E/A ratio(P <0.001) , increase MV deceleration (p<0.001) & significant increase of E/E’ (P 0.002 for lateral MV annulus &<0.001 for septal MV annulus )after VVI group with less significant decrease of E/A ratio (P 0.042), less significant increase of MV deceleration (P 0.038),less significant increase of E/E’ (P 0.34 Lateral & 0.015 for septal) of DDD group. As Regards RV function : Highly significant decrease of E/A of tricuspid flow (P <0.001)& increase E deceleration (P< 0.001)& increase E/E’ ratio (p <0.001) with VVI group with less significant decrease of tricuspid E/A ratio (P 0.045), increase E deceleration (P 0.045)& increase of E/E’ (P 0.034) of DDD group. As regards ventricular performance: Highly significant increase of Tie index of both LV & RV with both groups (p <0.001).Conclusion: chronic RV pacing induces LV/RV dysfunction regardless pacing Mode (VVI or DDD) that can be assessed by more accurate & sensitive parameters of systolic &diastolic dysfunction with tissue Doppler echocardiography.