Why the study?
RV apical pacing is known to cause detrimental effects on LV function long term, but limited data exist on alternative pacing sites that may help preserve LV function.
Does right ventricular septal pacing improve left ventricular function compared to right ventricular apical pacing in patients requiring permanent pacemakers?
Population
93 consecutive patients receiving RV pacing
Comparison
RV septal pacing vs RV apical pacing
Design
Consecutive observational cohort study
Follow-up
Median 6 years (interquartile range 4–9 years)
Key result
Right ventricular septal pacing was associated with better global longitudinal strain (-17.2 vs -15.1; P<0.001) compared to apical pacing, though LVEF did not differ significantly (P=0.112).
Authors
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May favor septal over apical pacing to preserve LV function; hypothesis-generating and requires confirmation in randomized trials.
Cohort (n=93)
Does right ventricular septal pacing improve left ventricular function compared to right ventricular apical pacing in patients requiring permanent pacemakers?
Absolute Event Rate: 51.5% vs 48.1%
p-value: p=0.112
Long-term right ventricular septal pacing preserves left ventricular longitudinal strain and reduces left atrial remodeling compared to traditional right ventricular apical pacing.
Goel et al. (2020) conducted a cohort in Permanent pacemaker implantation (n=93). Right ventricular septal pacing vs. Right ventricular apical pacing was evaluated on Left ventricular ejection fraction (LVEF) (p=0.112). Right ventricular septal pacing was associated with better global longitudinal strain (-17.2 vs -15.1; P<0.001) compared to apical pacing, though LVEF did not differ significantly (P=0.112).