Ventricular Synchrony in Targeted Right Ventricular Septal Pacing: A Prospective Paired Comparison to Apical...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Device Technology

Background:

• Conventional right ventricular (RV) apical pacing can lead to ventricular dyssynchrony and impaired cardiac function.
• Ventricular dyssynchrony is a significant concern in patients requiring pacemaker implantation.

Purpose of the Study:

• To evaluate if targeted RV septal pacing, guided by functional electrophysiological feedback, reduces ventricular dyssynchrony compared to standard apical pacing.
• To assess the impact of lead placement on cardiac synchrony.

Main Methods:

• Prospective observational study of 18 patients undergoing dual chamber pacemaker implantation.
• Comparison of baseline, RV apical pacing, and targeted RV septal pacing using ECG (QRS duration) and echocardiography (SPWD, IVMD).
• Functionally guided lead implantation targeting the RV septum.

Main Results:

• RV pacing, irrespective of lead position, increased ventricular dyssynchrony.
• Targeted RV septal pacing demonstrated significantly lower dyssynchrony (QRS duration, SPWD, IVMD) than RV apical pacing.
• No procedural complications were observed, and lead parameters were stable post-implantation.

Conclusions:

• Functionally guided RV septal pacing significantly reduces ventricular dyssynchrony compared to conventional apical pacing.
• This technique may offer a practical alternative to standard RV apical pacing.
• Further large-scale studies with long-term follow-up are warranted.