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Updated: May 9, 2026
06:14
Translational Rabbit Model of Chronic Cardiac Pacing
Published on: January 6, 2023
Potential prevention of pacing-induced heart failure using simple pacemaker programming algorithm.
Tomasz Chwyczko1, Rafał Dąbrowski, Aleksander Maciąg
1Second Coronary Artery Disease Department, Institute of Cardiology, Warsaw, Poland. tchwyczko@ikard.pl
Summary
Minimizing right ventricular pacing (RVP) in DDDR pacemaker patients significantly improved exercise capacity and left ventricular function compared to prolonged atrioventricular delay. This approach may prevent heart failure development.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Right ventricular pacing (RVP) can lead to ventricular desynchronization and heart failure (HF).
- Prolonging atrioventricular delay (AVD) in DDDR pacemakers can reduce unnecessary RV stimulation.
Purpose of the Study:
- To investigate the impact of reducing RVP on HF symptoms.
- To compare the effects of a fixed 150 ms AVD versus minimizing RVP (MRVP) on patient outcomes.
Main Methods:
- 31 patients with DDDR pacemakers for sinus node dysfunction were randomized to 150 ms AVD or MRVP.
- Patients underwent crossover after 4 months, with assessments at baseline, 4, and 8 months.
- Evaluations included cardiopulmonary exercise testing (CPX), echocardiography (ECHO), and BNP measurements.
Main Results:
- MRVP resulted in significantly less RVP (14.2%) compared to 150 ms AVD (81.7%).
- Patients in MRVP mode showed improved CPX parameters (peak oxygen uptake), lower BNP levels, and better left ventricle (LV) function (ejection fraction, diastolic diameter).
Conclusions:
- High rates of RVP in patients without baseline HF symptoms are associated with poorer exercise performance, elevated BNP, and impaired LV function.
- Specific DDDR pacemaker programming that promotes intrinsic AV conduction can potentially prevent pacing-induced heart failure.
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