Interv Akut Kardiol. 2007;6(4):135-138

Alternative right ventricular pacing site

Kateřina Lefflerová, Josef Kautzner

Klinika kardiologie, Institut klinické a experimentální medicíny, Praha

For nearly 50 years, the right ventricular apex (RVA) has been used as the elective pacing site for permanent pacing in bradyarrhythmias. Experimental and clinical studies, however, suggest that RVA pacing contributes to marked asynchrony of ventricular activation which is associated with abnormalities in regional coronary perfusion and metabolism. It might result in impairment of systolic and diastolic LV function. Long-term observational studies suggest that even structural changes may occur (remodelling). Alternative pacing sites which may reduce these adverse changes were tested in either acute or chronic studies, some of them have determined the superiority of more physiological ventricular pacing. We believe that there is a reason to change our clinical practise and not to continue in RVA pacing.

Keywords: permanent pacing, apical pacing, alternative site pacing, left ventricular remodeling

Published: October 23, 2007  Show citation