Focus on right ventricular outflow tract septal pacing.
Arch Cardiovasc Dis
; 106(6-7): 394-403, 2013.
Article
en En
| MEDLINE
| ID: mdl-23850059
Experimental and clinical studies have shown that right ventricular apical pacing may result in long-term deleterious effects on account of its negative impact on left ventricular remodeling through desynchronization. This risk appears more pronounced in patients with even moderate left ventricular dysfunction and generally occurs after at least 1 year of pacing. As right ventricular apical pacing may be associated with the development of organic mitral insufficiency, other sites that allow for more physiological stimulation, such as right ventricular outflow tract septal pacing, have been developed, with good feasibility and reproducibility. However, the prospective randomized studies and meta-analyses to date have only demonstrated a modest effect on ejection fraction in the medium term, without any significant effect on quality of life and morbimortality. However, the absence of a favorable effect for right ventricular outflow tract septal pacing compared with right ventricular apical pacing in terms of clinical manifestations and patient prognosis appears to be more associated with the designs of these studies, which were not homogeneous with regard to methodology used, judgment criteria, follow-up and, especially, statistical power. Two randomized prospective multicentre studies are currently ongoing in order to evaluate the favorable effect of infundibular septal pacing, when considering the indirect negative effects of right ventricular apical pacing as reported in the literature.
Palabras clave
AF; Apical pacing; CRT; DDD; Defibrillator; Défibrillateur; EF; HR; Infundibular pacing; LV; LVEF; Pacemaker; RV; RVAP; RVOT; Septal pacing; Stimulation apicale; Stimulation infundibulaire; Stimulation septale; VVI; atrial fibrillation; cardiac resynchronization therapy; dual-chamber pacemakers; ejection fraction; hazard ratio; left ventricle; left ventricular ejection fraction; right ventricle; right ventricular apical pacing; right ventricular outflow tract; single-chamber ventricular pacing
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Marcapaso Artificial
/
Estimulación Cardíaca Artificial
/
Función Ventricular Derecha
/
Tabique Interventricular
/
Insuficiencia Cardíaca
/
Ventrículos Cardíacos
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
Aspecto:
Patient_preference
Límite:
Humans
Idioma:
En
Revista:
Arch Cardiovasc Dis
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Francia
Pais de publicación:
Países Bajos