[Right ventricular pacing: a resource or a threat?].
Early after the beginning of the pacemaker era, endocardial right ventricular apex has been the most extensively used site for cardiac pacing because it was easily accessible and reliable in a long-term perspective. However many data have demonstrated that this kind of pacing is suboptimal from a physiologic point of view because it causes several adverse effects such as altered ventricular contraction geometry, mitral regurgitation, perfusion alterations and interference with myocardial ion channels which determine a worsening of left ventricular function. Several strategies have been proposed to solve these problems (alternative pacing sites, specific algorithms able to reduce the percentage of ventricular pacing) which are still under evaluation. In this review we analyzed the effects of right apical ventricular pacing and its possible alternatives.
Ciaramitaro
Gianfranco
G
U.O.C. di Cardiologia, Università degli Studi, A.O.U.P Paolo Giaccone, Palermo. GC40030@policlinico.pa.it
Sgarito
Giuseppe
G
Farinella
Michele
M
Prestifilippo
Pierpaolo
P
Assennato
Pasquale
P
Novo
Salvatore
S
D000465:Algorithms; D000818:Animals; D001281:Atrial Fibrillation / Q000209:etiology; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods; D003326:Coronary Circulation; D004285:Dogs; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D015201:Meta-Analysis as Topic; D008944:Mitral Valve Insufficiency / Q000209:etiology; D009200:Myocardial Contraction; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013318:Stroke Volume; D009626:Terminology as Topic; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology