Again I Say, Again: Avoid Pacing the Right Ventricle!

Findings from yet another study show the detriment of RV pacing; however, the benefits of CRT in patients with preserved LV function remain unclear.

Biventricular pacing, or cardiac resynchronization therapy (CRT), has been shown to benefit patients with reduced LV ejection fractions and NYHA class III heart failure symptoms and, more recently, those with NYHA class I or II symptoms (JW Cardiol Sep 1 2009). By contrast, although RV-only pacing has long been suspected of causing LV dysfunction and is thought to have resulted in worsened heart failure in the DAVID trial (JW Cardiol Feb 21 2003), evidence of its detrimental effects is relatively scarce.

In a multicenter, manufacturer-sponsored trial of RV pacing versus CRT in patients with preserved LV function, 177 patients received a CRT device and were randomized to programmed RV-only or biventricular pacing. The indication for pacing wa…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate