Key result
Right ventricular outflow tract pacing improved left ventricular systolic synchrony compared to apex pacing (P<0.05) but did not prevent cardiac remodeling or preserve systolic function at 12 months.
Why the study?
Does right ventricular outflow tract pacing improve ventricular synchrony, cardiac function, and remodeling compared to right ventricular apex pacing in patients with high or third-degree atrial ventricular block and normal cardiac function?
Population
96 consecutive patients with high or third-degree atrial ventricular block and normal cardiac function
Comparison
Right ventricular outflow tract (RVOT) pacing vs Right ventricular apex (RVA) pacing
Design
RCT, randomized into 2 groups
Follow-up
12 months
Authors
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RVOT pacing does not prevent remodeling or preserve function despite better synchrony; challenges use of synchrony as surrogate endpoint for site selection.
RCT (n=96)
randomized
Does right ventricular outflow tract pacing improve ventricular synchrony, cardiac function, and remodeling compared to right ventricular apex pacing in patients with high or third-degree atrial ventricular block and normal cardiac function?
p-value: p=<0.05
In patients with normal cardiac function requiring pacing, RVOT pacing improves LV systolic synchrony compared to RVA pacing but does not significantly affect cardiac remodeling or LV systolic function at 12 months.
Gong et al. (2009) conducted an RCT in High or third-degree atrial ventricular block with normal cardiac function (n=96). Right ventricular outflow tract (RVOT) pacing vs. Right ventricular apex (RVA) pacing was evaluated on Left ventricular systolic and diastolic synchrony, LV volumes, and function (p=<0.05). Right ventricular outflow tract pacing improved left ventricular systolic synchrony compared to apex pacing (P<0.05) but did not prevent cardiac remodeling or preserve systolic function at 12 months.
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