Why the study?
Does the choice of ventricular pacing site affect left ventricular function in children with atrioventricular block?
Does the choice of ventricular pacing site affect left ventricular function in children with atrioventricular block?
Chronic RV apical pacing in children with AV block can lead to pacing-induced dyssynchrony and cardiac failure, highlighting the importance of considering alternative pacing sites.
Supports caution with RV apical pacing in pediatric AV block; leaves open optimal site selection pending prospective trials.
Children with congenital or acquired atrioventricular block are provided with ventricular rate support from a pacing lead that traditionally is positioned at the right ventricular (RV) apex. However, RV apical pacing causes dyssynchronous electrical activation and left ventricular (LV) contraction, resulting in decreased LV function. Chronic RV apical pacing leads to deterioration of LV function and morphology, resulting in cardiac failure in approximately 7% of children. This review describes the pathophysiology of pacing-induced dyssynchronous LV activation and contraction, especially as a result of chronic RV apical pacing. Furthermore, this review provides an overview of the possible alternative pacing sites, such as the RV outflow tract, His-bundle, LV apex, and biventricular pacing.
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Vanagt et al. (2008) studied this question.
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