Right ventricular apical pacing: the unwanted model of cardiac stimulation?
José Carlos Pachón Mateos1, Enrique I Pachón Mateos, Juán Carlos Pachón Mateos
1Sao Paulo Heart Hospital Electrophysiology and Arrhythmia Service, Pacemaker Service of the Sao Paulo Cardiology Institute, Pacemaker Brazilian Registry, Brazil.
Abstract:
Despite having a huge benefit in enabling heart rate control, cardiac pacing by stimulating the right ventricular apex causes an artificial iatrogenic left bundle-branch block-like syndrome. As a result, QRS widening and cardiac wall desynchronization occurs. The problems caused by this undesirable pacemaker side effect have been ignored, as they are counteracted by the great benefit of cardiac rate correction. However, the compelling evidence about its harmful effect presented in this article cannot be disregarded and should start an attitude change toward alternate sites of ventricular pacing and preclusion of the right ventricular apex stimulation.
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