Comparison of Effectiveness of Right Ventricular Mid-septal Pacing Vs. Apical Pacing: a Randomized-controlled Trials

Overview

Journal Eur Heart J Suppl

Publisher Oxford University Press

Date 2017 May 24

PMID 28533725

Citations 5

Authors

Ming Bai

Qiang Li

Gaxue Jiang

Lu Zhang

Tao Wang

Zheng Zhang

Affiliations

Soon will be listed here.

Abstract

The aim of the present study was to compare conventional right ventricular apical pacing (RVAP) with right ventricular mid-septal pacing (RVMSP) in terms of echocardiographic and clinical/biologic features. Ninety-six patients with high-degree atrioventricular block were randomly allocated to RVMSP ( = 50) and RVAP ( = 46). Threshold and impedance, echocardiographic left ventricular ejection fraction, ventricular dyssynchrony features, and distance during a 6-min walk test and Minnesota Living with Heart Failure Questionnaire were determined at 6 and 12 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide were measured. At 6 months of follow-up, echocardiographic and clinical/biologic features showed no significant differences between two groups. The RVAP group had more intraventricular dyssynchrony and a trend towards a worse left ventricular ejection fraction compared with the RVMSP at 12 months of follow-up. However, no overt clinical benefits from RVMSP were found. Right ventricular mid-septal pacing was associated with decreased dyssynchrony and better left ventricular ejection fraction compared with the RVAP. Right ventricular mid-septal pacing could represent an alternative pacing site in selected patients to reduce the harmful effects of traditional RVAP.

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