Related Experiment Video
Updated: Aug 18, 2025
10:17
Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
849
Cardiomyopathy Associated with Right Ventricular Apical Pacing-Systematic Review and Meta-Analysis
Andrzej Osiecki1, Wacław Kochman1, Klaus K Witte2
1Department of Cardiovascular Diseases, Bielanski Hospital, Centre of Postgraduate Medical Education, Ceglowska 80 Street, 01-809 Warsaw, Poland.
Journal of Clinical Medicine
|December 11, 2022
Summary
Right ventricular apical pacing (RVAP) impairs left ventricular systolic function. This meta-analysis of 14 RCTs confirms RVAP is associated with progressive deterioration of left ventricular ejection fraction (LVEF).
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Pacing
Background:
- Bradyarrhythmias necessitate artificial ventricular pacing for treatment.
- Right ventricular apical pacing (RVAP) is a common pacing method.
- Concerns exist regarding RVAP's impact on left ventricular systolic function.
Purpose of the Study:
- To systematically assess randomized controlled trials (RCTs).
- To determine the effects of RVAP on left ventricular ejection fraction (LVEF).
Main Methods:
- Systematic literature search of Cochrane, PubMed, and EMBASE.
- Meta-analysis of 14 RCTs involving 885 patients.
- Random effects model used to estimate pooled mean difference (MD) and 95% confidence interval (CI).
Main Results:
- RVAP was associated with statistically significant impairment of left ventricular systolic function.
- A mean difference in LVEF of 3.35% (95% CI: 1.80-4.91) was observed between baseline and post-intervention.
- The findings indicate a measurable decline in LVEF due to RVAP.
Conclusions:
- The meta-analysis confirms RVAP is linked to progressive deterioration of left ventricular systolic function.
- This evidence supports concerns about the long-term effects of RVAP on cardiac performance.
More Related Videos
Related Concept Videos
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
31
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
31
01:25Cardiomyopathy I: Introduction and Classification
36
Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
36
01:30Cardiomyopathy II: Dilated Cardiomyopathy
19
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,...
19
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
17
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
17
01:29Cardiomyopathy V: Interprofessional Care
25
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
25
01:20Mitral Regurgitation I: Introduction
28
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...
28