Right ventricular apical pacing: the unwanted model of cardiac stimulation?
Despite having a huge benefit in enabling heart rate control, cardiac pacing by stimulating the right ventricular apex causes an artificial iatrogenic left bundle-branch block-like syndrome. As a result, QRS widening and cardiac wall desynchronization occurs. The problems caused by this undesirable pacemaker side effect have been ignored, as they are counteracted by the great benefit of cardiac rate correction. However, the compelling evidence about its harmful effect presented in this article cannot be disregarded and should start an attitude change toward alternate sites of ventricular pacing and preclusion of the right ventricular apex stimulation.
Pachón Mateos
José Carlos
JC
Sao Paulo Heart Hospital Electrophysiology and Arrhythmia Service, Pacemaker Service of the Sao Paulo Cardiology Institute, Pacemaker Brazilian Registry, Brazil.
Pachón Mateos
Enrique I
EI
Pachón Mateos
Juán Carlos
JC
D000818:Animals; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000628:therapy; D002037:Bundle-Branch Block / Q000209:etiology*; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects* / Q000379:methods; D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000209:etiology / Q000628:therapy; D006339:Heart Rate; D006352:Heart Ventricles; D006801:Humans; D010138:Pacemaker, Artificial