title: Right ventricular septal pacing: Safety and efficacy in a long term follow up.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of the permanent high interventricular septal pacing in a long term follow up, as alternative to right ventricular apical pacing.
  
  
  METHODS
  We retrospectively evaluated: (1) 244 patients (74 ± 8 years; 169 men, 75 women) implanted with a single (132 pts) or dual chamber (112 pts) pacemaker (PM) with ventricular screw-in lead placed at the right ventricular high septal parahisian site (SEPTAL pacing); (2) 22 patients with permanent pacemaker and low percentage of pacing (< 20%) (NO pacing); (3) 33 patients with high percentage (> 80%) right ventricular apical pacing (RVA). All patients had a narrow spontaneous QRS (101 ± 14 ms). We evaluated New York Heart Association (NYHA) class, quality of life (QoL), 6 min walking test (6MWT) and left ventricular function (end-diastolic volume, LV-EDV; end-systolic volume, LV-ESV; ejection fraction, LV-EF) with 2D-echocardiography.
  
  
  RESULTS
  Pacing parameters were stable during follow up (21 mo/patient). In SEPTAL pacing group we observed an improvement in NYHA class, QoL score and 6MWT. While LV-EDV didn't significantly increase (104 ± 40 mL vs 100 ± 37 mL; P = 0.35), LV-ESV slightly increased (55 ± 31 mL vs 49 ± 27 mL; P = 0.05) and LV-EF slightly decreased (49% ± 11% vs 53% ± 11%; P = 0.001) but never falling < 45%. In the RVA pacing control group we observed a worsening of NYHA class and an important reduction of LV-EF (from 56% ± 6% to 43% ± 9%, P < 0.0001).
  
  
  CONCLUSIONS
  Right ventricular permanent high septal pacing is safe and effective in a long term follow up evaluation; it could be a good alternative to the conventional RVA pacing in order to avoid its deleterious effects.
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Eraldo
authors: E
authors: Occhetta
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Gianluca
authors: G
authors: Quirino
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Lara
authors: L
authors: Baduena
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Rosaria
authors: R
authors: Nappo
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Chiara
authors: C
authors: Cavallino
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Emanuela
authors: E
authors: Facchini
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Paolo
authors: P
authors: Pistelli
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Andrea
authors: A
authors: Magnani
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Miriam
authors: M
authors: Bortnik
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Gabriella
authors: G
authors: Francalacci
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Gabriele
authors: G
authors: Dell'Era
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Laura
authors: L
authors: Plebani
authors: Eraldo Occhetta, Rosaria Nappo, Emanuela Facchini, Andrea Magnani, Miriam Bortnik, Gabriella Francalacci, Gabriele Dell'Era, Laura Plebani, Paolo Marino, Cardiology Department, AOU Maggiore della Carità, 28100 Novara, Italy.
authors: Paolo
authors: P
authors: Marino
keywords: Left ventricular cardiac function; Parahisian pacing; Permanent cardiac pacing; Resynchronization therapy; Right ventricular septal pacing