Adverse Effect of Ventricular Rate Regularization Pacing in Biventricular Cardiac Resynchronization Therapy
Chu-Pak Lau1, Kathy Lai-Fun Lee1, Hung-Fat Tse1,2,3
1Cardiology Division, Department of Medicine, School of Clinical Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
Journal of Cardiovascular Electrophysiology
|September 18, 2025
Summary
Ventricular rate regularization (VRR) can inappropriately increase pacing rates in CRT-D patients with frequent premature ventricular contractions (PVCs), potentially worsening heart failure. Disabling VRR normalized pacing rates in a case study.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Ventricular pacing strategies like ventricular rate regularization (VRR) aim to improve biventricular pacing and prevent ventricular tachycardias (VTs) triggered by premature ventricular contractions (PVCs).
- The potential for VRR to cause inappropriate rate increases during frequent PVCs, thereby exacerbating heart failure in CRT-D patients, remains underreported.
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