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

Occhetta, Eraldo; Quirino, Gianluca; Baduena, Lara; Nappo, Rosaria; Cavallino, Chiara; Facchini, Emanuela; Pistelli, Paolo; Magnani, Andrea; Bortnik, Miriam; Francalacci, Gabriella; Dell’Era, Gabriele; Plebani, Laura; Marino, Paolo

doi:10.4330/wjc.v7.i8.490

Cited by 14 publications

(8 citation statements)

References 30 publications

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“…A further 15 studies were excluded based on non-extractable data (6), no comparison between RVSP and RVAP (3), and having outcomes unrelated to LV function or structure (6). The remaining 29 studies met the eligibility criteria and were included for analysis [1,2,4,5,7,8,15,. Figure 1 provides a summary of the search process.…”

Section: Search Resultsmentioning

confidence: 99%

“…Three studies [17,34,36] adopted a crossover design while the remaining adopted a parallel design [1,2,4,5,7,8,15,18,19,[24][25][26][27][28][29][30][31][32][33]36]. Twenty-one studies [1,2,4,5,8,15,[17][18][19][26][27][28][29][30][31][32][33][34][36][37][38] provided LVEF values at baseline and after pacing, eight [2,4,8,15,31,32,37,38] of ...…”

Section: Study Characteristicsmentioning

confidence: 99%

“…For close to five decades, the right ventricular apical pacing (RVAP) has remained the mainstay of pacemaker implantation due to technical ease of transvenous lead placement, electrode stability and treatment efficacy [2][3][4]. Clinical data in the past five decades also suggest chronic RVAP improves quality of life and life expectancy [5,6]. However, in some patients, chronic RVAP has been associated with intra-and inter-ventricular dyssynchrony [6] resulting in negative hemodynamic changes such as decreased cardiac output, increased myocardial workload and oxygen consumption, and altered neuro-hormonal and electrophysiological activities [3,5].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical data in the past five decades also suggest chronic RVAP improves quality of life and life expectancy [5,6]. However, in some patients, chronic RVAP has been associated with intra-and inter-ventricular dyssynchrony [6] resulting in negative hemodynamic changes such as decreased cardiac output, increased myocardial workload and oxygen consumption, and altered neuro-hormonal and electrophysiological activities [3,5]. These hemodynamic changes can lead to the development of LV dysfunction, atrial fibrillation and heart failure [6].…”

Section: Introductionmentioning

confidence: 99%

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Right ventricular septal or apical? which is optimal positioning in pacemaker implantation: A systematic review and meta-analysis

Albakri¹,

Bimmel²

2020

Integr Mol Med

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Aims: Right ventricular (RV) apical pacing (RVAP) has been the preferred pacing site for decades but recent evidence suggests chronic RVAP can deteriorate cardiac function. RV septal pacing (RVSP) has emerged as an alternative site but its benefits over RVAP remain unclear. This meta-analysis aims to compare the effect of RVSP and RVAP on cardiac function.Methods: PubMed, EMBASE, and Cochrane were systematically searched for studies examining RVSP and RVAP. The inclusion criteria was randomized clinical trials comparing the effect of RVAP and RVSP on cardiac function and structure at follow-up. Data was pooled using random effects model. Results:Twenty-five studies (N=2,315 patients) randomized into RVAP (n=1,028) and RVSP (n=1,287) were included in this meta-analysis. Pooled data across the studies showed RVSP patients achieved significantly higher mean gain in LVEF at the end of follow-up (standardized mean difference: SMD, 0.394, 95% CI: 0.715-0.073), a narrower QRS duration (SMD, -1.172, 95% CI: 0.672-1.672) and lower levels of serum B-type natriuretic peptide (BNP) (SMD, 0.328, 95% CI: 0.039-0.617, p=0.02). Although RVSP showed a positive trend towards protecting against both LV dyssynchrony and remodelling as well as having better lead performance (R-wave, pacing threshold and impedance), the difference was not significant (p>0.01). Conclusion:In patients with significantly impaired LV systolic function who are eligible for RV pacing, RVSP may improve their LV function and lower serum BNP levels but may not protect them against ventricular dyssynchrony and remodeling.

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Section: Search Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Right ventricular septal or apical? which is optimal positioning in pacemaker implantation: A systematic review and meta-analysis

Albakri¹,

Bimmel²

2020

Integr Mol Med

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“…There are three basic types of permanent pacemakers, classified into: Single chamber pacemaker, dual chamber pacemaker, biventricular pacemaker [4].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Pacemaker Implantation among Patients in Tanta University Hospitals

Ayed

Nassar

Naseem

et al. 2022

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Background: This study describes cardiac pacing activity during 2021: demographic data of patients underwent permanent pacemaker implantation (PPM), risk factors, clinical presentations, indications, mode of pacing, and complications post PPM implantation. Cardiac pacemakers have become the common treatment of symptomatic bradycardia or high-grade atrioventricular block. Methods: The study was carried out at the department of cardiology Tanta University Hospitals. 102 patients were included in this study. This study was done over a period of six months from October 2020 until April 2021 and follow up for 6 months. All the data about the patients underwent permanent pacemaker implantation were collected by the coordinator in the participating cardiac center. Results: The most frequent risk factors of PPM implantation was hypertension (69%), followed by diabetes mellitus (29%), coronary artery disease (21%), chronic kidney disease (18%), hypothyroidism (6%), cardiomyopathy (3%), valvular heart disease (2%) and congenital heart disease (1%). The most common indication is complete heart block (69%), followed by second degree heart block "mobeitz type 2" (13%), slow atrial fibrillation (7%), symptomatic heart failure patients with LVEF ≤ 35% , QRS ≥ 150 ms (6%), trifascicular block (3%), sick sinus syndrome (2%). The most frequent mode of pacing used in our study was DDD mode (63%), followed by VVI mode (32%) with (78%) sinus rhythm and (22%) atrial fibrillation rhythm, then CRT-D (4%). Overall complication rate (9%) within 6 months. In our study the most common complication is infection (5%), followed by haematoma (1%), lead fracture (1%), pneumothorax (1%), and lead displacement (1%). Conclusion: Approximately three-quarters of the patients related to atrioventricular block underwent permanent pacemaker implantaion. Approximately more than half of pacemakers related to patients underwent permanent pacemaker implantation were dual chamber pacemakers. Infection is the most common complication in our study and this is important for strict infection control measures.

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Cardiac Pacemakers

Huízar¹,

Ellenbogen²

2017

Cardiac Arrhythmias, Pacing and Sudden Death

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

Abstract: Right ventricular permanent high septal pacing is safe and effective in a long term follow up evaluation; it could be a good alternative to the conventional RVA pacing in order to avoid its deleterious effects.

Cited by 14 publications

References 30 publications

Right ventricular septal or apical? which is optimal positioning in pacemaker implantation: A systematic review and meta-analysis

Right ventricular septal or apical? which is optimal positioning in pacemaker implantation: A systematic review and meta-analysis

Epidemiology of Pacemaker Implantation among Patients in Tanta University Hospitals

Cardiac Pacemakers

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