title: Survival analysis in patients with preserved left ventricular function and standard indications for permanent cardiac pacing randomized to right ventricular apical or septal outflow tract pacing.
abstract: BACKGROUND
  Optimal right ventricular (RV) pacing site in patients referred for permanent cardiac pacing remains controversial. A prospective randomized trial was done to compare long-term effect of permanent RV apex (RVA) vs RV outflow tract (RVOT) pacing on the all-cause and cardiovascular mortality.
  
  
  RESULTS
  A total of 122 consecutive patients (70 men, 69 +/-11 years), with standard pacing indications were randomized to RVA (66 patients) or RVOT (56 patients) ventricular lead placement. After the 10-year follow-up period the mortality data were summarized on the basis of an intention-to-treat analysis. During the long-term follow-up, 31 patients from the RVA group died vs 24 patients in the RVOT group (hazard ratio (HR), 0.96; 95% confidence interval (CI), 0.57-1.65; P=0.89). There were 10 cardiovascular deaths in the RVA and 12 in the RVOT group (HR, 1.04; 95%CI, 0.45-2.41; P=0.93). There were no differences in the all-cause or cardiovascular mortality between the pacing sites after adjustment for age, gender, arterial hypertension, atrial fibrillation, New York Heart Association class and left ventricular end-diastolic diameter.
  
  
  CONCLUSIONS
  The RVOT provides no additional benefit in terms of long-term survival over RVA pacing.
authors.affiliation: Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Poland. adabrowska@amg.gda.pl
authors.forename: Alicja
authors.initials: A
authors.lastname: Dabrowska-Kugacka
authors.forename: Ewa
authors.initials: E
authors.lastname: Lewicka-Nowak
authors.forename: Sebastian
authors.initials: S
authors.lastname: Tybura
authors.forename: Rajmund
authors.initials: R
authors.lastname: Wilczek
authors.forename: Justyna
authors.initials: J
authors.lastname: Staniewicz
authors.forename: Paweł
authors.initials: P
authors.lastname: Zagozdzon
authors.forename: Anna
authors.initials: A
authors.lastname: Faran
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kozłowski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Raczak
authors.forename: Grazyna
authors.initials: G
authors.lastname: Swiatecka
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006352:Heart Ventricles; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011859:Radiography; D018570:Risk Assessment; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D054088:Ventricular Septum