@article{16022,
  author = {Alhous M. and Broadhurst P. and Hillis Graham and Small G. and Hannah A.},
  title = {Impact of temporary right ventricular pacing from different sites on echocardiographic indices of cardiac function},
  abstract = {<p>
AIMS: To assess the impact of pacing from different right ventricular (RV) pacing sites on left ventricular (LV) function. Chronic apical RV pacing may induce heart failure. To reduce this RV, mid-septum and outflow tract are suggested as alternative pacing sites. We therefore assessed cardiac performance during temporary RV pacing from apical vs. mid-septum or outflow tract sites, using echocardiography and electrocardiography. METHODS AND RESULTS: Patients scheduled for a permanent pacemaker underwent temporary pacing in dual-chamber mode (DDD) and with atrio-ventricular delay optimized. The ventricular lead was moved to either the RV apex, mid-septum or outflow tract. Comprehensive echocardiography was performed in each position. Twenty-two patients completed the study. The baseline data was collected at atrial pacing mode (AAI). QRS duration lengthened with RV apical pacing (97 +/- 22 ms AAI vs. 154 +/- 18 ms RV apical, P &lt; 0.001) and shortened with mid-septum or outflow tract pacing (147 +/- 14 ms RV mid-septum and 136 +/- 16 ms RV outflow tract, P = 0.001 and P &lt; 0.001, respectively, vs. RV apical). Right ventricular apical pacing was associated with reductions in stroke volume and LV ejection fraction (54 +/- 6% AAI vs. 48 +/- 5% RV apical, P = 0.001). Right ventricular mid-septum (52 +/- 5%) and outflow tract (54 +/- 6%) pacing improved LV ejection fraction in comparison with apical pacing (P &lt; 0.01 for both). Pacing at all sites induced dyssynchrony. In comparison with RV apical pacing dyssynchrony was reduced by mid-septum or outflow tract pacing. CONCLUSIONS: Right ventricular pacing at the mid-septum or outflow tract results in narrower QRS complexes, less dyssynchrony, and better LV systolic function than RV apical pacing.
</p>
},
  year = {2011},
  journal = {Europace},
  volume = {13},
  edition = {2011/07/19},
  number = {12},
  pages = {1738-46},
  isbn = {1532-2092 (Electronic)1099-5129 (Linking)},
  note = {Alhous, M Hafez ASmall, Gary RHannah, AndrewHillis, Graham SBroadhurst, PaulComparative StudyResearch Support, Non-U.S. Gov'tEnglandEuropace. 2011 Dec;13(12):1738-46. Epub 2011 Jul 14.},
  language = {eng},
}