OptimalPacing.com
In recent years, there has been a growing body of evidence that suggests chronic right ventricular (RV) apical pacing can cause a variety of adverse effects in patients, particularly those with intact atrial-ventricular (AV) function. Studies have demonstrated that atrial fibrillation (AF), left ventricular dysfunction, and congestive heart failure may either arise or be exacerbated by the mechanical dyssynchrony and ventricular chamber dysfunction that occur with chronic, apical ventricular stimulation.
The Danish Study, CTOPP, MOST Sub-Study, and DAVID clinical trials all either directly or indirectly show benefits of preserving intrinsic AV conduction or the intrinsic ventricular activation sequence whenever possible. Long-term risks associated with chronic RV apical pacing have been identified. Studies suggest that clinical efforts should be attempted to optimize pacing strategies, significantly decrease unnecessary RV pacing, and promote normal activation. Among solutions are novel pacing algorithms or modes and selective site pacing.
Topics related to optimal pacing include:
- Right Ventricular Pacing
- Selective Site Pacing
- Biventricular Pacing for AV Conduction Delay or Block
- Long-term Surveillance of Heart Failure and AF