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©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Cardiol. Nov 26, 2013; 5(11): 410-419
Published online Nov 26, 2013. doi: 10.4330/wjc.v5.i11.410
Published online Nov 26, 2013. doi: 10.4330/wjc.v5.i11.410
The importance of avoiding unnecessary right ventricular pacing in clinical practice
Finn Akerström, Miguel A Arias, Marta Pachón, Jesús Jiménez-López, Alberto Puchol, Justo Juliá-Calvo, Cardiac Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hospital Virgen de la Salud, 45004 Toledo, Spain
Author contributions: All the authors contributed to this work.
Correspondence to: Dr. Miguel A Arias, Cardiac Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hospital Virgen de la Salud, Unidad de Arritmias y Electrofisiología Cardiaca, Avda. Barber 30, Planta Semisótano, 45004 Toledo, Spain. maapalomares@secardiologia.es
Telephone: +34-925-265492 Fax: +34-925-265492
Received: June 26, 2013
Revised: September 20, 2013
Accepted: October 11, 2013
Published online: November 26, 2013
Processing time: 160 Days and 9.6 Hours
Revised: September 20, 2013
Accepted: October 11, 2013
Published online: November 26, 2013
Processing time: 160 Days and 9.6 Hours
Core Tip
Core tip: A high amount of long-term right ventricular (RV) pacing produces ventricular dyssynchrony and clinical deterioration in patients with reduced left ventricular ejection fraction (LVEF). In this patient group, cardiac resynchronization therapy has been shown to improve clinical outcomes and should be considered before a conventional pacemaker. In subjects with normal LVEF, the deleterious effects of RV pacing is less clear; however, specific pacemaker algorithms that minimize RV pacing may improve clinical outcomes in selected patients. Future studies will help to better identify those at risk of suffering the negative effects of RV pacing and define the correct use of preventive therapeutic strategies.