The effects of right ventricular apical pacing on ventricular function and dyssynchrony implications for therapy

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Cardiac pacing is essential for sick sinus syndrome and atrioventricular conduction disorders.
• Conventional pacing uses the right ventricular (RV) apex.
• Concerns exist regarding RV apical pacing's adverse effects on cardiac structure and function.

Purpose of the Study:

• To review evidence on detrimental effects of RV apical pacing.
• To discuss alternatives to conventional RV pacing.
• To examine cardiac resynchronization therapy (CRT) and alternative RV pacing sites.

Main Methods:

• Review of existing literature and clinical trial data.
• Analysis of observational studies on pacing outcomes.
• Evaluation of evidence linking RV apical pacing to ventricular dyssynchrony.

Main Results:

• RV apical pacing may induce ventricular dyssynchrony.
• This dyssynchrony is potentially linked to impaired left ventricular function and heart failure development.
• CRT may reverse some deleterious effects of RV pacing.

Conclusions:

• RV apical pacing might have long-term detrimental effects on cardiac function.
• Cardiac resynchronization therapy (CRT) is a potential alternative.
• Alternative RV pacing sites and CRT should be considered for patients with pacemaker indications.