{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:17:30Z","timestamp":1788419850463,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High right ventricular pacing burden is a well\u2010established risk factor for the development of left ventricular dysfunction and pacing\u2010induced cardiomyopathy (PICM). However, identification of post\u2010implant patients at risk for PICM remains challenging. This meta\u2010analysis evaluated the association between global longitudinal strain (GLS) by speckle tracking echocardiography (STE) and the risk of subsequent development of PICM in patients who undergo pacemaker implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We searched the databases PubMed, Embase, and Web of Science for studies reporting an association between early (&lt;1 month) and late (&gt;1 month) post\u2010implant GLS measurement and subsequent development of PICM on long\u2010term follow\u2010up. The search was not restricted to time or publication status. Results were reported as mean difference (MD) with 95% confidence intervals (CIs) and\n                      <jats:italic>p<\/jats:italic>\n                      values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 6 studies with 455 patients (74 with eventual PICM, 381 without PICM) met inclusion criteria. The mean follow\u2010up was 15 months, mean age was 69.2 years, and 48.6% were men. The mean ventricular pacing burden was 88.8%. Both early post\u2010implant GLS (MD 4.98, 95% CI 3.84\u20136.12;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01) and long\u2010term post\u2010implant GLS (MD 5.35, 95% CI 3.83\u20136.88;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01) were significantly reduced in patients who eventually developed PICM; a positive MD indicates a less negative (more impaired) GLS in the PICM group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GLS values are significantly reduced both early and late after pacemaker implantation in patients who subsequently develop PICM. Impaired post\u2010implant GLS measured by STE was associated with an increased risk of subsequently developing PICM. Whether GLS can be used to identify at\u2010risk patients in clinical practice remains to be established in prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70417","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:02:26Z","timestamp":1788418946000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Global Longitudinal Strain and Pacing\u2010Induced Cardiomyopathy: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3358-4458","authenticated-orcid":false,"given":"David T.","family":"Zhang","sequence":"first","affiliation":[{"name":"Electrophysiology Section, Division of Cardiology Department of Medicine Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1417-252X","authenticated-orcid":false,"given":"Rachel M.","family":"Suen","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Stony Brook Medicine  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakshum","family":"Chadha","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Stony Brook Medicine  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenney","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Medicine Stony Brook Medicine  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5461-2480","authenticated-orcid":false,"given":"Matthew","family":"Pelletier","sequence":"additional","affiliation":[{"name":"Department of Medicine Stony Brook Medicine  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelle N.","family":"Mann","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Stony Brook Medicine  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1615-8446","authenticated-orcid":false,"given":"Michael","family":"Tao","sequence":"additional","affiliation":[{"name":"Heart &amp; Vascular Institute Hartford Healthcare Medical Group  Hartford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"issue":"9","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1016\/j.hrthm.2014.05.040","article-title":"Incidence and Predictors of Right Ventricular Pacing\u2010induced Cardiomyopathy","volume":"11","author":"Khurshid S.","year":"2014","journal-title":"Heart Rhythm"},{"issue":"12","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"2272","DOI":"10.1016\/j.hrthm.2016.09.027","article-title":"Incidence and Predictors of Right Ventricular Pacing\u2010induced Cardiomyopathy in Patients With Complete Atrioventricular Block and Preserved Left Ventricular Systolic Function","volume":"13","author":"Kiehl E. L.","year":"2016","journal-title":"Heart Rhythm"},{"issue":"23","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"2932","DOI":"10.1161\/01.CIR.0000072769.17295.B1","article-title":"Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation among Patients With Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction","volume":"107","author":"Sweeney M. O.","year":"2003","journal-title":"Circulation"},{"issue":"2","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1093\/europace\/eur258","article-title":"Pacing\u2010Induced Cardiomyopathy in Patients With Right Ventricular Stimulation for >15 Years","volume":"14","author":"Dreger H.","year":"2012","journal-title":"Europace"},{"issue":"9","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.jacc.2009.06.006","article-title":"The Effects of Right Ventricular Apical Pacing on Ventricular Function and Dyssynchrony Implications for Therapy","volume":"54","author":"Tops L. F.","year":"2009","journal-title":"Journal of the American College of Cardiology"},{"issue":"6","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1016\/S0735-1097(99)00068-6","article-title":"Mapping of Regional Myocardial Strain and Work During Ventricular Pacing: Experimental Study Using Magnetic Resonance Imaging Tagging","volume":"33","author":"Prinzen F. W.","year":"1999","journal-title":"Journal of the American College of Cardiology"},{"issue":"2","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.jcmg.2017.11.017","article-title":"Assessment of Left Ventricular Function by Echocardiography: The Case for Routinely Adding Global Longitudinal Strain to Ejection Fraction","volume":"11","author":"Potter E.","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"issue":"15","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1093\/eurheartj\/ehv529","article-title":"Myocardial Strain Imaging: How Useful Is It in Clinical Decision Making?","volume":"37","author":"Smiseth O. A.","year":"2016","journal-title":"European Heart Journal"},{"issue":"14","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1093\/eurheartj\/ehu304","article-title":"Effect of Right Ventricular Pacing Lead Site on Left Ventricular Function in Patients With High\u2010Grade Atrioventricular Block: Results of the Protect\u2010Pace Study","volume":"36","author":"Kaye G. C.","year":"2015","journal-title":"European Heart Journal"},{"issue":"1","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjci\/jeu184","article-title":"Definitions for a Common Standard for 2D Speckle Tracking Echocardiography: Consensus Document of the EACVI\/ASE\/Industry Task Force to Standardize Deformation Imaging","volume":"16","author":"Voigt J. U.","year":"2015","journal-title":"European Heart Journal\u2014Cardiovascular Imaging"},{"issue":"3","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.echo.2011.01.015","article-title":"Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE\/EAE Consensus Statement on Methodology and Indications Endorsed by the Japanese Society of Echocardiography","volume":"24","author":"Mor\u2010Avi V.","year":"2011","journal-title":"Journal of the American Society of Echocardiography"},{"issue":"25","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"2751","DOI":"10.1016\/j.jacc.2014.01.073","article-title":"Use of Myocardial Strain Imaging by Echocardiography for the Early Detection of Cardiotoxicity in Patients During and after Cancer Chemotherapy: A Systematic Review","volume":"63","author":"Thavendiranathan P.","year":"2014","journal-title":"Journal of the American College of Cardiology"},{"issue":"9","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.echo.2014.07.012","article-title":"Expert Consensus for Multimodality Imaging Evaluation of Adult Patients During and after Cancer Therapy: A Report From the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"27","author":"Plana J. C.","year":"2014","journal-title":"Journal of the American Society of Echocardiography"},{"issue":"10","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1093\/ehjci\/jes115","article-title":"Global Longitudinal Strain Is a Strong Independent Predictor of All\u2010Cause Mortality in Patients With Aortic Stenosis","volume":"13","author":"Kearney L. G.","year":"2012","journal-title":"European Heart Journal\u2014Cardiovascular Imaging"},{"issue":"4","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.jcmg.2014.06.013","article-title":"Practical Guidance in Echocardiographic Assessment of Global Longitudinal Strain","volume":"8","author":"Negishi K.","year":"2015","journal-title":"JACC Cardiovasc Imaging"},{"issue":"4","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.hrthm.2013.12.020","article-title":"Right Ventricular Apical Pacing\u2010Induced Left Ventricular Dyssynchrony Is Associated With a Subsequent Decline in Ejection Fraction","volume":"11","author":"Ahmed M.","year":"2014","journal-title":"Heart Rhythm"},{"issue":"1","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0162072","article-title":"One\u2010Month Global Longitudinal Strain Identifies Patients Who Will Develop Pacing\u2010Induced Left Ventricular Dysfunction Over Time: The Pacing and Ventricular Dysfunction (PAVD) Study","volume":"12","author":"Ahmed F. Z.","year":"2017","journal-title":"PLoS ONE"},{"issue":"2","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s10840-023-01650-5","article-title":"Pacing\u2010Induced Cardiomyopathy in Patients With Preserved Ejection Fraction Undergoing Permanent Cardiac Pacemaker Placement","volume":"67","author":"Cho J. Y.","year":"2024","journal-title":"Journal of Interventional Cardiac Electrophysiology"},{"issue":"1","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s43044-021-00136-x","article-title":"Predictors of Pacing Induced Left Ventricular Dysfunction and Cardiomyopathy Assessed by Three\u2010Dimensional Echocardiography and Speckle Tracking Strain","volume":"73","author":"Dawood M.","year":"2021","journal-title":"Egyptian Heart Journal"},{"issue":"1","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","DOI":"10.31083\/RCM26173","article-title":"Post\u2010Implant Global Longitudinal Strain as a Predictor of Pacing\u2010Induced Cardiomyopathy in Patients With Preserved Ejection Fraction Undergoing Pacemaker Placement","volume":"26","author":"Kim S. S.","year":"2025","journal-title":"Reviews in Cardiovascular Medicine"},{"issue":"2","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.4103\/jiae.jiae_11_20","article-title":"Value of Speckle Tracking Echocardiography as a Predictor of the Deleterious Effect of Right Ventricular Pacing on Left Ventricular Function","volume":"4","author":"Rafla S.","year":"2020","journal-title":"Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging"},{"issue":"1","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred Reporting Items for Systematic Review and Meta\u2010Analysis Protocols (PRISMA\u2010P) 2015 Statement","volume":"4","author":"Moher D.","year":"2015","journal-title":"Syst Rev"},{"issue":"7414","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring Inconsistency in Meta\u2010Analyses","volume":"327","author":"Higgins J. P.","year":"2003","journal-title":"BMJ"},{"issue":"3","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.echo.2007.08.045","article-title":"Right Ventricular Apical Pacing Acutely Impairs Left Ventricular Function and Induces Mechanical Dyssynchrony in Patients With Sick Sinus Syndrome: A Real\u2010Time Three\u2010Dimensional Echocardiographic Study","volume":"21","author":"Liu W. H.","year":"2008","journal-title":"Journal of the American Society of Echocardiography"},{"issue":"4","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S0735-1097(96)00586-4","article-title":"Long\u2010Term Effect of Right Ventricular Pacing on Myocardial Perfusion and Function","volume":"29","author":"Tse H. F.","year":"1997","journal-title":"Journal of the American College of Cardiology"},{"issue":"2","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s10741-021-10091-z","article-title":"The Therapeutic Effects of Upgrade to Cardiac Resynchronization Therapy in Pacing\u2010Induced Cardiomyopathy or Chronic Right Ventricular Pacing Patients: A Meta\u2010Analysis","volume":"27","author":"Lu W.","year":"2022","journal-title":"Heart Failure Reviews"},{"issue":"11","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1007\/s00392-021-01927-7","article-title":"Outcomes of Conduction System Pacing Compared to Right Ventricular Pacing as a Primary Strategy for Treating Bradyarrhythmia: Systematic Review and Meta\u2010Analysis","volume":"111","author":"Abdin A.","year":"2022","journal-title":"Clinical Research in Cardiology"},{"issue":"35","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","article-title":"2021 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy","volume":"42","author":"Glikson M.","year":"2021","journal-title":"European Heart Journal"},{"issue":"2","key":"e_1_2_11_30_1","first-page":"135","article-title":"Acute Effects of Right Ventricular Apical Pacing on Left Ventricular Synchrony and Mechanics","volume":"2","author":"Delgado V.","year":"2009","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"issue":"7","key":"e_1_2_11_31_1","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1253\/circj.CJ-10-1138","article-title":"Right Ventricular Septal Pacing Preserves Global Left Ventricular Longitudinal Function in Comparison With Apical Pacing: Analysis of Speckle Tracking Echocardiography","volume":"75","author":"Inoue K.","year":"2011","journal-title":"Circulation Journal"},{"issue":"8","key":"e_1_2_11_32_1","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1136\/heartjnl-2014-306990","article-title":"Dyssynchrony, Contraction Efficiency and Regional Function With Apical and Non\u2010Apical RV Pacing","volume":"101","author":"Saito M.","year":"2015","journal-title":"Heart"},{"issue":"2","key":"e_1_2_11_33_1","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.jsha.2017.06.001","article-title":"Three\u2010Dimensional Echocardiography With Left Ventricular Strain Analyses Helps Earlier Prediction of Right Ventricular Pacing\u2010Induced Cardiomyopathy","volume":"30","author":"Babu N. M. S.","year":"2018","journal-title":"Journal of the Saudi Heart Association"},{"issue":"5","key":"e_1_2_11_34_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/pace.14701","article-title":"Reduction of Left Ventricular Global Longitudinal Strain in Patients With Permanent Pacemakers as a Predictor of Heart Failure and Mortality Outcomes","volume":"46","author":"Manocha K.","year":"2023","journal-title":"Pacing and Clinical Electrophysiology"},{"issue":"1","key":"e_1_2_11_35_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ihj.2023.01.001","article-title":"Strain Echocardiography in Predicting LV Dysfunction in RV Apical Pacing","volume":"75","author":"Datta G.","year":"2023","journal-title":"Indian Heart Journal"},{"issue":"10","key":"e_1_2_11_36_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.echo.2015.06.011","article-title":"Head\u2010to\u2010Head Comparison of Global Longitudinal Strain Measurements Among Nine Different Vendors: The EACVI\/ASE Inter\u2010Vendor Comparison Study","volume":"28","author":"Farsalinos K. 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