What question did this study set out to answer?

To assess the effects of ventricular rate regularization combined with right ventricular apical versus septal pacing on left ventricular function and exercise capacity in permanent atrial fibrillation.

April 10, 2009EP EuropaceOpen Access

Impacts of ventricular rate regularization pacing at right ventricular apical vs. septal sites on left ventricular function and exercise capacity in patients with permanent atrial fibrillation

View Full Paper

Ask AI

Bookmark

Why the study?

Does right ventricular septal pacing with ventricular rate regularization improve left ventricular function and exercise capacity compared to right ventricular apical pacing in patients with permanent atrial fibrillation and symptomatic bradycardia?

Population

24 patients with permanent atrial fibrillation and symptomatic bradycardia

Comparison

Right ventricular septal pacing with a… vs Right ventricular apical pacing with a…

Design

RCT, Randomized

Follow-up

24 months

Authors

HTHung‐Fat TseElectrophysiology KWKwong‐Kwok WongThe University of Texas MD Anderson Cancer Center CSChung‐Wah SiuElectrophysiology

Discussion

Member takes

Implication

Favors RVS over RVA pacing with VRR in permanent AF bradycardia; extends RCT evidence supporting non-apical sites to preserve LV function.

Key Points

To assess the effects of ventricular rate regularization combined with right ventricular apical versus septal pacing on left ventricular function and exercise capacity in permanent atrial fibrillation.
Randomized 24 patients with permanent atrial fibrillation and symptomatic bradycardia to either right ventricular apical (RVA, n = 12) or right ventricular septal (RVS, n = 12) pacing.
Programmed a ventricular rate regularization (VRR) algorithm for all participants at 6 months after pacemaker implantation.
Assessed exercise performance via 6-minute hall walk (6MHW) at 6, 12, and 24 months, and left ventricular ejection fraction (LVEF) by radionuclide ventriculography at 6 and 24 months.
Pacing QRS duration was significantly shorter during RVS pacing than RVA pacing (132 ± 4 vs. 151 ± 6 ms, P = 0.012).
VRR significantly increased ventricular pacing percentage and reduced rate variability in both arms (P < 0.05) without altering mean ventricular rate (P > 0.05).
At 24 months, RVA pacing led to significant decreases in LVEF and 6MHW (P < 0.05), whereas RVS pacing preserved LVEF and significantly improved 6MHW (P < 0.05).

Structured PICO

Population

24 patients with permanent atrial fibrillation and symptomatic bradycardia

Intervention

Right ventricular septal (RVS) pacing with a ventricular rate regularization (VRR) algorithm programmed at 6 months after implantation

Comparator

Right ventricular apical (RVA) pacing with a ventricular rate regularization (VRR) algorithm programmed at 6 months after implantation

Outcome

Left ventricular ejection fraction (LVEF) assessed by radionuclide ventriculography and exercise capacity assessed by 6 minute hall walk (6MHW) at 24 monthssurrogate

In patients with permanent atrial fibrillation and symptomatic bradycardia, right ventricular septal pacing with ventricular rate regularization preserves left ventricular ejection fraction and improves exercise capacity compared to right ventricular apical pacing.

Cite This Study

Tse et al. (2009) studied this question.

synapsesocial.com/papers/6a0ecaa7aa1655e5fb22ce26 https://doi.org/10.1093/europace/eup087

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes

View Full Paper

Ask AI

Bookmark

Implication

Favors RVS over RVA pacing with VRR in permanent AF bradycardia; extends RCT evidence supporting non-apical sites to preserve LV function.

Impacts of ventricular rate regularization pacing at right ventricular apical vs. septal sites on left ventricular function and exercise capacity in patients with permanent atrial fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Impacts of ventricular rate regularization pacing at right ventricular apical vs. septal sites on left ventricular function and exercise capacity in patients with permanent atrial fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider