title: Feasibility and effect of para-right bundle branch pacing in patients with atrial fibrillation and complete atrioventricular block.
abstract: BACKGROUND
  Chronic right ventricular apex (RVA) pacing can induce negative clinical effects. The aim of the present study was to compare RVA pacing with para-right bundle branch (para-RBB) pacing in terms of electrocardiogram (ECG) and echocardiographic (ECHO) features.
  
  
  METHODS
  Forty-one consecutive persistent atrial fibrillation patients with an indication for permanent pacing treatment due to complete atrioventricular block were randomly assigned to receive a screw-in lead either in the RVA (n = 22) or at the para-RBB (n = 19). Para-RBB pacing leads were located according to the RBB potential recorded by electrophysiology catheter. ECG was recorded before and after implantation. All patients underwent the pacemaker programming at 1 day, 6 months, 12 months and 24 months after implantation. ECHO examination was performed during follow-up at 6, 12 and 24 months after implantation to assess the heart function and synchronism.
  
  
  RESULTS
  There was no significant difference in pacing lead parameters between para-RBB pacing group and RVA pacing group. Compared with RVA pacing group, the para-RBB pacing group obtained a narrower QRS complex, more synchronic ventricular systole, and less negative effect on heart function (p < 0.05).
  
  
  CONCLUSIONS
  Para-RBB pacing has potential clinical benefits and may be a physiological pacing site.
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Zhengzhou University Zhengzhou. duyouyou_008@163.com.
authors.forename: You-You
authors.initials: YY
authors.lastname: Du
authors.forename: Rui
authors.initials: R
authors.lastname: Yao
authors.forename: Qing-Hua
authors.initials: QH
authors.lastname: Chen
authors.forename: Luo-Sha
authors.initials: LS
authors.lastname: Zhao
authors.forename: Ling
authors.initials: L
authors.lastname: Li
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D054537:Atrioventricular Block / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002681:China; D004452:Echocardiography; D004562:Electrocardiography; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D016896:Treatment Outcome