title: Development of mitral and tricuspid regurgitation in right ventricular apex versus right ventricular outflow tract pacing.
abstract: OBJECTIVE
  This study aimed at comparing the development of tricuspid and mitral regurgitation between the right ventricular outflow tract (RVOT) and right ventricular apex (RVA) pacing.
  
  
  METHODS
  We prospectively enrolled 164 patients for permanent pacemaker implantation due to sick sinus syndrome or atrioventricular block and randomly divided them into two equal groups to receive either RVOT or RVA pacing. Patients with heart failure or valvular disease were excluded. The post-procedural echocardiographic evaluations were performed 1 year after the pre-procedural echocardiography, and the results were compared with respect to the development of mitral and tricuspid regurgitation and probable changes in the ejection fraction (EF).
  
  
  RESULTS
  Age, gender, pacing mode, and baseline cardiac rhythm did not significantly differ between the RVOT and RVA pacing groups. The incidence of mitral regurgitation was significantly higher in the RVA group (p = 0.03), but the incidence of tricuspid regurgitation was similar in both groups. There was a trend toward less tricuspid regurgitation in the RVOT group; however, it was not statistically significant. The mean EF was not significantly different between the study groups.
  
  
  CONCLUSIONS
  It seems that the incidence of mitral regurgitation in RVA pacing is significantly higher than that in RVOT pacing. The formation of tricuspid regurgitation needs to be discussed in the future.
  
  
  BACKGROUND
  IRCT201103146061N1.
authors.affiliation: Faculty of Medicine, Islamic Azad University, Tehran, Iran.
authors.forename: Sevil
authors.initials: S
authors.lastname: Hemayat
authors.forename: Akbar
authors.initials: A
authors.lastname: Shafiee
authors.forename: Saeed
authors.initials: S
authors.lastname: Oraii
authors.forename: Farideh
authors.initials: F
authors.lastname: Roshanali
authors.forename: Farshid
authors.initials: F
authors.lastname: Alaedini
authors.forename: Amirhossein Sami
authors.initials: AS
authors.lastname: Aldoboni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects* / Q000379:methods; D004567:Electrodes, Implanted; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology*; D016037:Single-Blind Method; D013318:Stroke Volume; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology*; D014463:Ultrasonography