Related Experiment Video
Updated: May 26, 2026
12:45
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Right ventricular pacing, mechanical dyssynchrony, and heart failure.
Alan J Bank1, Ryan M Gage, Kevin V Burns
1United Heart and Vascular Clinic, 225 N. Smith Ave. #400, St. Paul, MN 55102, USA. Alan.Bank@allina.com
Journal of Cardiovascular Translational Research
|December 23, 2011
Summary
Right ventricular (RV) pacing for heart block can cause heart failure by creating electrical dyssynchrony. Strategies to mitigate this risk include biventricular pacing and optimized RV pacing techniques.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Cardiac pacing, particularly right ventricular (RV) apical pacing, is a standard treatment for sick sinus syndrome and atrioventricular block.
- While effective in managing heart block symptoms, RV pacing can lead to detrimental effects on cardiac structure and function, potentially causing heart failure (HF).
Purpose of the Study:
- To review the detrimental effects of RV pacing on cardiac function and explore strategies to prevent or treat pacing-induced heart failure.
- To highlight the mechanisms of RV pacing-induced cardiac dyssynchrony and its impact on myocardial metabolism and function.
Main Methods:
- Review of existing studies on RV pacing effects on cardiac structure and function.
- Analysis of mechanisms leading to intraventricular mechanical dyssynchrony.
- Evaluation of current and investigational strategies for prevention and treatment.
Main Results:
- RV pacing can induce electrical and mechanical dyssynchrony, mimicking left-bundle branch block.
- Myocardial metabolism, structure, and function are impaired both regionally near the pacing site and globally in the left ventricle.
- Pacing-induced HF is a recognized complication of RV apical pacing.
Conclusions:
- Strategies such as biventricular pacing, optimized RV pacing programming, alternative RV pacing sites, and echocardiographic screening are being investigated to mitigate RV pacing-induced HF.
- Early detection and intervention, including upgrading to biventricular pacing, are crucial for managing patients at risk.
Related Concept Videos
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:17Pathophysiology of Heart Failure
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:26Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...