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. 2012 May;12(3):102-13.
doi: 10.1016/s0972-6292(16)30502-2. Epub 2012 May 20.

The downside of right ventricular apical pacing

Andrew Brenyo  1 , Ilan Goldenberg, Alon Barsheshet
Affiliations

The downside of right ventricular apical pacing

Andrew Brenyo et al. Indian Pacing Electrophysiol J. 2012 May.

Abstract

The right ventricular (RV) apex has been the standard pacing site since the development of implantable pacemaker technology. Although RV pacing was initially only utilized for the treatment of severe bradyarrhythmias usually due to complete heart block, today the indications for and implantation of RV pacing devices is dramatically larger. Recently, the adverse effects of chronic RV apical pacing have been described including an increased risk of heart failure and death. This review details the detrimental effects of RV apical pacing and their shared hemodynamic pathophysiology. In particular, the role of RV apical pacing induced ventricular dyssynchrony is highlighted with a specific focus on differential outcome based upon QRS morphology at implant.

Keywords: down side; right ventricular pacing.

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Figures

Figure 1
Figure 1
Probability of long-term mortality by percent of right ventricular pacing and ICD implantation in the MADIT II trial with extended follow up. (reproduced with permission of the publisher [9])
Figure 2
Figure 2
Probability of long-term mortality by percent of right ventricular pacing in patients with LBBB (A) and without LBBB (B) in the MADIT II trial with extended follow up. (reproduced with permission of the publisher [9])
Figure 2
Figure 2
Probability of long-term mortality by percent of right ventricular pacing in patients with LBBB (A) and without LBBB (B) in the MADIT II trial with extended follow up. (reproduced with permission of the publisher [9])
See this image and copyright information in PMC

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