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Journal of Cardiovascular Translational Research
Published in: Journal of Cardiovascular Translational Research 2/2012

01-04-2012

Right Ventricular Pacing, Mechanical Dyssynchrony, and Heart Failure

Authors: Alan J. Bank, Ryan M. Gage, Kevin V. Burns

Published in: Journal of Cardiovascular Translational Research | Issue 2/2012

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Abstract

Cardiac pacing is a common treatment option for patients with sick sinus syndrome or atrioventricular block, with the ventricular pacing lead often secured in the convenient right ventricular (RV) apical location. While RV pacing reduces symptoms and limitations associated with heart block, it may have detrimental effects on cardiac structure and function, leading to heart failure (HF) in some patients. RV pacing creates electrical dyssynchrony similar to a left-bundle branch block, with conduction occurring cell-by-cell rather than through the His–Purkinje network. Studies have shown that impairment of myocardial metabolism, structure, and function related to RV pacing occurs regionally (most prominently near the pacing site) and globally, within the left ventricle. Strategies being studied to prevent or treat pacing-induced intraventricular mechanical dyssynchrony and HF include: initial biventricular rather than RV pacing in selected patients, programming to avoid or minimize RV pacing, use of alternate (non-apical) RV pacing sites, echocardiographic screening for development of pacing-induced dyssynchrony and HF, and upgrade to biventricular pacing.
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Metadata
Title
Right Ventricular Pacing, Mechanical Dyssynchrony, and Heart Failure
Authors
Alan J. Bank
Ryan M. Gage
Kevin V. Burns
Publication date
01-04-2012
Publisher
Springer US
Published in
Journal of Cardiovascular Translational Research / Issue 2/2012
Print ISSN: 1937-5387
Electronic ISSN: 1937-5395
DOI
https://doi.org/10.1007/s12265-011-9341-8

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