Mohan B, Batta A. Dual-chamber pacing confers better myocardial performance and improves clinical outcomes compared to single-chamber pacing. World J Cardiol 2024; 16(11): 626-631 [PMID: 39600992 DOI: 10.4330/wjc.v16.i11.626]
Corresponding Author of This Article
Akash Batta, DM, MD, Academic Editor, Academic Research, Assistant Professor, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana 141001, Punjab, India. akashbatta02@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Nov 26, 2024; 16(11): 626-631 Published online Nov 26, 2024. doi: 10.4330/wjc.v16.i11.626
Dual-chamber pacing confers better myocardial performance and improves clinical outcomes compared to single-chamber pacing
Bishav Mohan, Akash Batta
Bishav Mohan, Akash Batta, Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Co-first authors: Bishav Mohan and Akash Batta.
Author contributions: Mohan B and Batta A designed the editorial, supervised the study and provided key feedback and suggestions; Batta A performed the literature review and data collection, analyzed the data and wrote the manuscript and subsequently revised it. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akash Batta, DM, MD, Academic Editor, Academic Research, Assistant Professor, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana 141001, Punjab, India. akashbatta02@gmail.com
Received: September 15, 2024 Revised: September 29, 2024 Accepted: October 15, 2024 Published online: November 26, 2024 Processing time: 46 Days and 5.4 Hours
Abstract
The deleterious effects of long term right ventricular pacing are increasingly being recognized today. Current clinical practice favors the implantation of dual-chamber permanent pacemaker which maintains atrioventricular synchrony and is associated with better quality of life. However, despite the popular belief and common sense surrounding the superiority of dual-chamber pacing over single chamber pacing, the same has never been conclusively verified in clinical trials. Some observational evidence however, does exists which supports the improved cardiac hemodynamics, lower the rate of atrial fibrillation, heart failure and stroke in dual-chamber pacing compared to single-chamber pacing. In the index study by Haque et al, right ventricular pacing, particularly in ventricular paced, ventricular sensed, inhibited response and rate responsive pacemaker adversely impacted the left ventricular functions over 9-months compared to dual pacing, dual sensing, dual responsive and rate responsive pacemaker. Although there are key limitations of this study, these findings does support a growing body of evidence reinstating the superiority of dual chamber pacing compared to single chamber pacing.
Core Tip: The detrimental effects of long-term apical right ventricular pacing (RVP) on left ventricular (LV) functions have necessitated the search for strategies to mitigate pacing-induced cardiomyopathy. Amongst them, allowing for a more physiological pacing and reducing the RVP burden by appropriate programming are the most clinically relevant interventions. The index study by the authors supports a net beneficial effect of dual responsive and rate responsive (DDDR) compared to ventricular paced, ventricular sensed, inhibited response and rate responsive (VVIR) mode in terms of better LV function and performance in the short-term by maintaining the atrio-ventricular synchrony. Further, as in prior studies, new-onset AF was more frequent with VVIR compared to DDDR.
