title: Right ventricular outflow tract septal pacing is superior to right ventricular apical pacing.
abstract: BACKGROUND
  The effects of right ventricular apical pacing (RVAP) and right ventricular outflow tract (RVOT) septal pacing on atrial and ventricular electrophysiology have not been thoroughly compared.
  
  
  RESULTS
  To identify a more favorable pacing strategy with fewer adverse effects, 80 patients who had complete atrioventricular block with normal cardiac function and who were treated with either RVAP (n=42) or RVOT septal pacing (n=38) were recruited after an average of 2 years of follow-up. The data from electrocardiography and echocardiography performed before pacemaker implantation and at the end of follow-up were collected. The patients in the RVOT septal pacing and RVAP groups showed similar demographic and clinical characteristics before pacing treatments. After a mean follow-up of 2 years, the final maximum P-wave duration; P-wave dispersion; Q-, R-, and S-wave complex duration; left atrial volume index; left ventricular end-systolic diameter; ratio of transmitral early diastolic filling velocity to mitral annular early diastolic velocity; and interventricular mechanical delay in the RVOT septal pacing group were significantly less than those in the RVAP group (P<0.05). The final left ventricular ejection fraction of the RVOT septal pacing group was significantly higher than that of the RVAP group (P<0.05).
  
  
  CONCLUSIONS
  Compared with RVAP, RVOT septal pacing has fewer adverse effects regarding atrial electrical activity and structure in patients with normal cardiac function.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, China (C.Z., J.S., H.L., X.Y.).
authors.forename: Cao
authors.initials: C
authors.lastname: Zou
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, China (C.Z., J.S., H.L., X.Y.).
authors.forename: Jianping
authors.initials: J
authors.lastname: Song
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, China (C.Z., J.S., H.L., X.Y.).
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Electrocardiography, First Affiliated Hospital of Soochow University, Suzhou, China (X.H., Y.L.).
authors.forename: Xingmei
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Electrocardiography, First Affiliated Hospital of Soochow University, Suzhou, China (X.H., Y.L.).
authors.forename: Yuping
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Echocardiography, First Affiliated Hospital of Soochow University, Suzhou, China (C.Z., X.S.).
authors.forename: Caiming
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Echocardiography, First Affiliated Hospital of Soochow University, Suzhou, China (C.Z., X.S.).
authors.forename: Xin
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, China (C.Z., J.S., H.L., X.Y.).
authors.forename: Xiangjun
authors.initials: X
authors.lastname: Yang
mesh_terms: D054537:Atrioventricular Block; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D016896:Treatment Outcome; D016278:Ventricular Function, Right / Q000502:physiology; D054088:Ventricular Septum / Q000502:physiology
keywords: cardiovascular diseases; electrophysiology; pacemaker