title: Pacing-induced heart disease: understanding the pathophysiology and improving outcomes.
abstract: Pacemaker implantation remains the only therapeutic option that improves morbidity and mortality for patients with symptomatic bradycardia. However, pacing from the right ventricular apex can induce dyssynchronous activation of the ventricles, increase sympathetic activation, cause abnormalities in myocardial perfusion, worsen cardiac output and endothelial function and may be associated with adverse cardiovascular outcomes. This article reviews the current knowledge on the pathophysiology of pacing-induced cardiovascular disease and current strategies to avoid and mitigate the adverse effects of right ventricular pacing.
authors.affiliation: Centre for Cardiovascular and Lung Biology, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
authors.forename: Douglas H J
authors.initials: DH
authors.lastname: Elder
authors.forename: Chim C
authors.initials: CC
authors.lastname: Lang
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Choy
mesh_terms: D000818:Animals; D001919:Bradycardia / Q000628:therapy*; D002302:Cardiac Output; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects* / Q000379:methods; D006331:Heart Diseases / Q000209:etiology* / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D010138:Pacemaker, Artificial; D018754:Ventricular Dysfunction / Q000209:etiology / Q000503:physiopathology