Right ventricular septal pacing: Safety and efficacy in a long term follow up

Table 1 Comparison of pre-implantation clinical features in the patient control groups (NO pacing and right ventricular apical pacing) and parahisian pacing group

	NO pacing	RVA pacing	PH pacing
Total patients	22 patients	33 patients	244 patients
Age (yr)	75 ± 7	77 ± 9	74 ± 8
Sex	13 M/9 F	21 M/12 F	169 M/ 75 F
NYHA class	1.09 ± 0.29	1.15 ± 0.36	2.13 ± 0.46
LV ejection fraction (%)	57 ± 5	55 ± 8	53 ± 11
LV end-dyastolic volume (cc)	89 ± 25	98 ± 22	100 ± 37
LV end-systolic volume (cc)	38 ± 13	47 ± 17	49 ± 27
Associated heart diseases	Ischemic heart disease: 6/22 (27%) Valvular heart disease: 2/22 (9%) Hypertensive heart disease: 2/22 (9%) No significant heart disease: 12/22 (55%)	Ischemic heart disease: 12/33 (37%) Valvular heart disease: 4/33 (12%) Hypertensive heart disease: 3/33 (9%) No significant heart disease: 14/33 (42%)	Ischemic heart disease: 80/244 (33%) Valvular heart disease: 29/244 (12%) Hypertensive heart disease: 90/244 (37%) No significant heart disease: 45/244 (18%)
Atrial fibrillation	1 (5%)	4 (12%)	132 (54%)
Sinus rhythm	21 (95%)	29 (88%)	112 (46%)

Comparison of pre-implantation clinical features in the patient control groups [NO pacing and right ventricular apical (RVA) pacing] and parahisian (PH) pacing group. NYHA: New York Heart Association; LV: Left ventricular.

Table 2 Long term follow up results of parahisian pacing

	Basal	Parahisian pacing	P value
NYHA class (167 pts)	2.15 ± 0.51	1.59 ± 0.55	< 0.001
6-min walk (m) (70 pts)	354 ± 90	400 ± 88	0.03
QoL (score) (70 pts)	29 ± 18	19 ± 7	0.02
LV-EDV (mL) (121 pts)	100 ± 37	104 ± 40	0.35
LV-ESV (mL) (121 pts)	49 ± 27	55 ± 31	0.05
LV-EF (%) (121 pts)	53 ± 11	49 ± 11	0.01

NYHA: New York Heart Association; QoL: Quality of life; LV-EDV: Left ventricular end diastolic volume; LV-ESV: Left ventricular end systolic volume; LV-EF: Left ventricular ejection fraction.

Table 3 New York Heart Association functional class before implantation and at follow-up, in patients with a low percentage of stimulation (NO pacing), with apical pacing (right ventricular apical pacing) and with parahisian pacing groups

	NO pacing(22 pts)	RVA pacing(33 pts)	PH pacing(167 pts)
Baseline	1.09 ± 0.29	1.15 ± 0.36	2.15 ± 0.51
Follow-up	1.22 ± 0.52	1.88 ± 0.99	1.59 ± 0.55
Significance	0.32 (ns)	P < 0.05	P < 0.001
	Unchanged	Worsening	Improvement

RVA: Right ventricular apical; PH: Para hisian.

Table 4 Evolution of echocardiographic parameters: end-diastolic volume, end-systolic volume and ejection fraction in the NO pacing group (22/22 patients), in the right ventricular apical pacing group (33/33 patients) and in the parahisian group (121/230 patients)

		Basal	Follow-up	P
Contr (22 pts)	EDV (mL)	88 ± 25	99 ± 46	0.23 (ns)
	ESV (mL)	38 ± 13	46 ± 29	0.11 (ns)
	EF (%)	57 ± 5	56 ± 5	0.1 (ns)
RVA (33 pts)	EDV (mL)	98 ± 23	139 ± 31	< 0.0001
	ESV (mL)	44 ± 14	79 ± 22	< 0.0001
	EF (%)	56 ± 6	43 ± 9	< 0.0001
PH (121 pts)	EDV (mL)	100 ± 37	104 ± 40	0.35 (ns)
	ESV (mL)	49 ± 27	55 ± 31	0.05
	EF (%)	53 ± 11	49 ± 11	0.01