What does this research mean for the field?

Right ventricular apical pacing leads to significant deterioration in right ventricular mechanical function, including reduced global longitudinal and free wall strain, one year after implantation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate changes in right ventricular mechanical function following right ventricular apical pacemaker implantation.

March 6, 2026Turkiye Klinikleri Cardiovascular SciencesOpen Access

Effect of Right Ventricular Apical Pacing on Right Ventricular Function: Prospective Cohort Study

Q: What is the clinical evidence from this study?

Study design: Prospective Cohort. Population: Patients undergoing right ventricular apical pacing. Intervention: Right ventricular apical pacing.

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Key result

RV apical pacing shows no effect on RV function at one year versus baseline.

Why the study?

Relatively few studies have investigated the effect of right ventricular apical pacing on right ventricular function compared to the left ventricle.

Does right ventricular apical pacing reduce right ventricular mechanical function in patients requiring pacemaker implantation?

Comparison

1 year after right ventricular apical pacing vs pre-implantation baseline

Design

Prospective cohort study

Follow-up

1 year

Authors

AKAtilla KOYUNCU CYCennet YILDIZ EOErsan OFLAR

Discussion

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Implication

May warrant nonapical sites to preserve RV mechanics; extends LV dyssynchrony concerns to RV strain in observational data.

Key Points

To evaluate changes in right ventricular mechanical function following right ventricular apical pacemaker implantation.
Conducted echocardiographic assessments, including tissue Doppler and strain imaging, before implantation and 1 year after the procedure.
Right ventricular global longitudinal strain significantly worsened from pre-implantation to 1 year post-implantation (-21.72±4.47% vs. -16.56±4.22%, p<0.001), as did right ventricular free wall strain (-26.95±4.23% vs. -21.27±3.79%, p<0.001).
Statistically significant decreases occurred in TAPSE, tricuspid annulus systolic velocity, and fractional area change after pacing, though values remained within normal limits.
No significant differences were observed in right ventricular outflow tract diameter or left ventricular ejection fraction before versus after pacemaker implantation.

Study Design

Type

Prospective Cohort

Structured PICO

Does right ventricular apical pacing reduce right ventricular mechanical function in patients requiring pacemaker implantation?

Population

55 patients who underwent pacemaker implantation in a tertiary cardiology clinic, mean age 65.05±14.64 years, 54.5% female. Primary indication was complete atrioventricular block (n=40, 72.7%).

Intervention

Right ventricular apical pacing (majority received DDD-R pacemaker, n=45, 81.8%) for 1 year

Comparator

Pre-implantation baseline values (intra-patient comparison)

Outcome

Right ventricular function assessed by echocardiography (including tissue Doppler imaging and strain imaging) at 1 year after implantationsurrogate

Right ventricular apical pacing is associated with a significant deterioration in right ventricular mechanical function, specifically longitudinal and free wall strain, at 1 year post-implantation.

Cite This Study

KOYUNCU et al. (2026) conducted a prospective cohort in Patients undergoing right ventricular apical pacing. Right ventricular apical pacing was evaluated. null.

synapsesocial.com/papers/69aa7077531e4c4a9ff5a444 https://doi.org/10.5336/cardiosci.2025-114554

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Effect of Right Ventricular Apical Pacing on Right Ventricular Function: Prospective Cohort Study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Effect of Right Ventricular Apical Pacing on Right Ventricular Function: Prospective Cohort Study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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