Since pacing for bradycardia began in the 1960 s, physicians and medical device companies have focused on improving the software, hardware and longevity of implantable device, without paying substantial attention to the optimal pacing site within the right ventricle (RV). Historically, apical pacing within the RV was chosen as it was easily accessible, the lead placements were relatively stable and/or rates of dislodgement/infections were low. However, more recent studies have suggested potential deleterious effects of long-term RV apical pacing: i.e., some degree of induced heart failure with associated decreased hemodynamic [1] or ventricular function [2]. Both short-term [3] and long-term [4] studies on humans have confirmed these suggested adverse effects, more specifically including, abnormal ventricular activation times, right and left ventricular dysfunctions, which have been linked to genesis of heart failure. These observations have fuelled growing interest...

References

References
1.
Cock
,
C. C.
,
Giudici
,
M. C.
, and
Twisk, J. W.
,
2003
, “
Comparison of the Haemodynamic Effects of Right Ventricular Outflow-Tract Pacing With Right Ventricular Apex Pacing: A Quantitative Review
,”
Europace
,
5
, pp.
275
278
.
2.
Deshmukh
,
P.
,
Casavant
,
D. A.
,
Romanyshyn
,
M.
, and
Anderson
,
K.
,
2000
. “
Permanent, Direct His-Bundle Pacing: A Novel Approach to Cardiac Pacing in Patients With Normal His-Purkinje Activation
,”
Circulation
,
101
, pp.
869
877
.10.1161/01.CIR.101.8.869
3.
Karpawich
,
P.
, and
Mital
,
S.
,
1997
. “
Comparative Left Ventricular Function Following Atrial, Septal, and Apical Single Chamber Heart Pacing in the Young
,”
Pacing Clin Electrophysiol
,
20
, pp.
1983
1988
.10.1111/j.1540-8159.1997.tb03605.x
4.
Tse
,
H. F.
, and
Lau
,
C. K.
,
1997
. “
Long Term Effects of Right Ventricular Pacing on Myocardial Perfusion and Function
,”
J. Am. Coll. Cardiol.
,
29
, pp.
744
749
.10.1016/S0735-1097(96)00586-4
5.
Agur
,
A. M. R.
, and
Dalley
,
A. F.
,
12th Edition.
Grant's, Atlas of Anatomy
.
Lippincott Williams & Wilkins
,
New York
, p.
57
.
6.
Benchimol
,
A.
, and
Liggett
,
M. S.
,
1966
. “
Cardiac Hemodynamics During Stimulation of the Right Atrium, Right Ventricle, and Left Ventricle in Normal and Abnormal Hearts
,”
Circulation
,
33
, pp.
933
944
.10.1161/01.CIR.33.6.933
7.
Hillock
,
R. J.
,
Stevenson
,
I. H.
, and
Mond
,
H. G.
,
2007
. “
The Right Ventricular Outflow Tract: A Comparative Study of Septal, Anterior Wall, and Free Wall Pacing
,”
Pacing Clin. Electrophysiol.
,
30
, pp.
942
947
.10.1111/j.1540-8159.2007.00790.x
8.
Vlay
,
S. C.
,
2006
, “
Right Ventricular Outflow Tract Pacing: Practical and Beneficial. A 9-Year Experience of 460 Consecutive Implants
,”
Pacing Clin. Electrophysiol.
,
29
(
10
), pp.
1055
1062
.10.1111/j.1540-8159.2006.00498.x
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