Pacing site in pacemaker dependency: is right ventricular septal lead position the answer?

Kaye, Gerry (2014) Pacing site in pacemaker dependency: is right ventricular septal lead position the answer?. Expert Review of Cardiovascular Therapy, 12 12: 1407-1417. doi:10.1586/14779072.2014.979791


Author Kaye, Gerry
Title Pacing site in pacemaker dependency: is right ventricular septal lead position the answer?
Journal name Expert Review of Cardiovascular Therapy   Check publisher's open access policy
ISSN 1744-8344
1477-9072
Publication date 2014-12-01
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1586/14779072.2014.979791
Volume 12
Issue 12
Start page 1407
End page 1417
Total pages 11
Place of publication London United Kingdom
Publisher Expert Reviews
Collection year 2015
Language eng
Abstract The right ventricular apex has been the traditional site for lead placement in patients with atrioventricular block. Pacing at the right ventricular apex may have long-term deleterious effects on left ventricular (LV) function, promoting heart failure and increasing mortality. Pacing at the right ventricular septum has been proposed to minimize deterioration in LV function. Although experimental data suggest that septal pacing protects LV function, clinical studies have provided conflicting results. A recent large study in patients with heart block did not show a protective effect with septal pacing. Other pacing approaches are becoming increasingly relevant; however, prediction of what method should be employed in which patient is not currently possible. Other factors such as baseline LV function and associated co-morbidities impact LV function, irrespective of pacing site. Continued monitoring of cardiac function post-implant is therefore critical to ongoing care. An algorithm for managing patients with atrioventricular block is proposed.
Keyword Alternate site pacing
Atrioventricular block
Cardiac resynchronization therapy
Heart failure
Left ventricular function
Right ventricular apical pacing
Right ventricular septal pacing
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2015 Collection
School of Medicine Publications
 
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