title: Finding the sweet spot for non-apical RV pacing - "love's labor's lost or much ado about nothing:" a new angiographic technique to accomplish accurate physiological RV septal pacing in under 5 minutes from venous cannulation (or bust).
abstract: Right ventricular septal pacing has been long touted as a more physiologic alternative to right ventricular apical pacing. This article reviews the physiologic and clinical evidence for right ventricular septal versus apical pacing, and presents a novel angiographic technique for efficient attainment of the optimal septal pacing site. The reasons for equivocal clinical findings in septal versus apical pacing studies are discussed, and a new strategy for non-apical pacing clinical trial design utilizing comparative anatomic assessment of septal pacing site versus clinical outcome is proposed.
authors.affiliation: Interventional Cardiology and Electrophysiology, St Agnes Medical Center, Fresno, CA, 93721 USA. sanjaysrivatsa@hotmail.com.
authors.forename: Sanjay S
authors.initials: SS
authors.lastname: Srivatsa
mesh_terms: D000792:Angiography / Q000379:methods*; D001145:Arrhythmias, Cardiac / Q000628:therapy; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D002404:Catheterization / Q000379:methods*; D004562:Electrocardiography; D006333:Heart Failure / Q000628:therapy; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D013997:Time Factors; D016896:Treatment Outcome; D016278:Ventricular Function, Right / Q000502:physiology*; D054088:Ventricular Septum / Q000000981:diagnostic imaging* / Q000502:physiology*