Key result
Right ventricular apical pacing resulted in a significantly greater 6-minute walk test distance compared to left ventricular pacing at six months (median 540.5 m vs 446.5 m, p=0.015), demonstrating less detrimental effects on LV synchrony.
Why the study?
Because pacing from the RV apex is not considered optimal, this study aimed to compare RV and LV pacing regarding LV function and dyssynchrony.
Does left ventricular pacing improve LV function and dyssynchrony compared to right ventricular pacing in patients with indications for pacemakers?
Observational (n=48)
No
Does left ventricular pacing improve LV function and dyssynchrony compared to right ventricular pacing in patients with indications for pacemakers?
Absolute Event Rate: 446.5% vs 540.5%
p-value: p=0.015
Right ventricular apical pacing remains an appropriate standard for patients with normal or mildly impaired LV function (EF > 35%) requiring pacing.
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LV pacing may limit dyssynchrony versus RV apical pacing; leaves open need for outcome trials before practice change.
Elkholy et al. (2022) conducted an observational in Indications for permanent pacemaker implantation (e.g., sick sinus syndrome, complete heart block) (n=48). Left ventricular pacing vs. Right ventricular pacing was evaluated on 6-minute walk test distance at 6 months (p=0.015). Right ventricular apical pacing resulted in a significantly greater 6-minute walk test distance compared to left ventricular pacing at six months (median 540.5 m vs 446.5 m, p=0.015), demonstrating less detrimental effects on LV synchrony.
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