Adverse effect of right ventricular pacing prevented by biventricular pacing during long-term follow-up: a randomized comparison

Abstract

www.clinicaltrials.gov (identification number: NCT00228241).

Adverse Effects of Long‐Term Right Ventricular Apical Pacing and Identification of Patients at Risk of Atrial Fibrillation and Heart Failure

“…In the RV pacing group, LVEF progressively decreased over time from the first to the second year of follow‐up, but it remained unchanged in the CRT group, leading to a significant difference of 9.9 percentage points between groups at 2‐year follow‐up (P < 0.001). Similarly, Albertsen et al 31 randomized 50 patients with normal cardiac function to RV pacing or CRT. LVEF differed significantly between the two groups during 3 years of pacing (P = 0.003).…”

“…A baseline LVEF cut‐off value has not yet been clearly defined 32,33 . Based on data from some studies involving patients with AV junction ablation for AFib and also patients with standard indication for pacing, chronic RV pacing can induce a reduction in LVEF of 5–10 percentage points, depending on baseline characteristics and time to evaluation after implantation 24–26,28–31 (Table II). Therefore, a baseline LVEF cut‐off value of 40–45% should be discussed as a criterion for a CRT device in patients in whom RV pacing cannot be avoided.…”

Network meta‐analysis of His bundle, biventricular, or right ventricular pacing as a primary strategy for advanced atrioventricular conduction disease with normal or mildly reduced ejection fraction

“…We included 10 studies, of which three had additional reports with long‐term follow‐up results. Six studies compared BiVP and RVP, 11,13‐19 and four compared HBP and RVP 3,4,20‐22 . Figure 1 summarizes the search strategy.…”

Impact of physiologic pacing versus right ventricular pacing among patients with left ventricular ejection fraction greater than 35%: A systematic review for the 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay

“…To avoid potential double counting of subjects, we excluded 4 studies that reported results for the same trial populations. Eight studies comprised the final analysis, 4 comparing BiVP versus RVP (N5438) [28][29][30][31] and 4 evaluated HisBP versus RVP (N5241) 25,[32][33][34] (Figure 2). The characteristics of the studies are summarized in Data Supplements 5 and 6.…”

“…Three studies reported the impact of BiVP on 6minute walk distances and detected no significant difference with BiVP (MD: 6.736 m; 95% CI: -2.82 to 16.29 m; p50.167; I 2 5 0%). [28][29][30] Two of the studies observed no significant improvement in 6-minute walk distances. 28,30 The third study, which evaluated patients with chronic atrial fibrillation (AF) who underwent atrioventricular node ablation, found that at 6 months there was a significant improvement with both RV or BiVP but that BiVP resulted in a greater improvement in 6-minute walk distance (61.2690 m versus 82.9694.7 m; p50.04).…”