open access

Vol 14, No 3 (2007)
Review articles
Published online: 2007-03-30
Submitted: 2013-01-14
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Dual-site right ventricular pacing. A rescue alternative in cardiac resynchronisation therapy implantation failure? More efficient stimulation for patients with borderline cardiac resynchronisation therapy indication? Less harmful ventricular pacing?

Marcin Gułaj, Tomasz Sodolski, Andrzej Kutarski
Cardiol J 2007;14(3):224-231.

open access

Vol 14, No 3 (2007)
Review articles
Published online: 2007-03-30
Submitted: 2013-01-14

Abstract

Permanent cardiac pacing is nowadays a widespread method for the cure of conduction system diseases, improving quality of life and often saving patients’ lives. In the twentieth century, scientific efforts were focused on extending battery life, improving sensitivity and reliability, minimizing the dimensions of the device and restoring atrio-ventricular synchrony and rate response. However, there is more and more evidence for the deleterious influence of chronic right ventricular pacing especially apical (RVA) pacing. DANISH, MOST, CTOPP and DAVID trials have proven univocally that right ventricular pacing increases risk of heart failure, atrial fibrillation and even mortality in patients with chronic heart failure. Such knowledge inspires the quest for alternative pacing sites. Right ventricular outflow tract (RVOT) became the most favourable non-apical pacing site. Since 1995 there have been several reports concerning dual-site right ventricular pacing (DuVP: RVOT plus RVA pacing) proving its beneficial clinical and hemodynamic outcome especially in the case of unsuccessful left ventricle implantation for cardiac resynchronisation therapy (CRT). (Cardiol J 2007; 14: 224-231)

Abstract

Permanent cardiac pacing is nowadays a widespread method for the cure of conduction system diseases, improving quality of life and often saving patients’ lives. In the twentieth century, scientific efforts were focused on extending battery life, improving sensitivity and reliability, minimizing the dimensions of the device and restoring atrio-ventricular synchrony and rate response. However, there is more and more evidence for the deleterious influence of chronic right ventricular pacing especially apical (RVA) pacing. DANISH, MOST, CTOPP and DAVID trials have proven univocally that right ventricular pacing increases risk of heart failure, atrial fibrillation and even mortality in patients with chronic heart failure. Such knowledge inspires the quest for alternative pacing sites. Right ventricular outflow tract (RVOT) became the most favourable non-apical pacing site. Since 1995 there have been several reports concerning dual-site right ventricular pacing (DuVP: RVOT plus RVA pacing) proving its beneficial clinical and hemodynamic outcome especially in the case of unsuccessful left ventricle implantation for cardiac resynchronisation therapy (CRT). (Cardiol J 2007; 14: 224-231)
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Keywords

dual-site right ventricular pacing; bifocal right ventricular pacing; right ventricular outflow tract pacing; alternative ventricular pacing sites

About this article
Title

Dual-site right ventricular pacing. A rescue alternative in cardiac resynchronisation therapy implantation failure? More efficient stimulation for patients with borderline cardiac resynchronisation therapy indication? Less harmful ventricular pacing?

Journal

Cardiology Journal

Issue

Vol 14, No 3 (2007)

Pages

224-231

Published online

2007-03-30

Bibliographic record

Cardiol J 2007;14(3):224-231.

Keywords

dual-site right ventricular pacing
bifocal right ventricular pacing
right ventricular outflow tract pacing
alternative ventricular pacing sites

Authors

Marcin Gułaj
Tomasz Sodolski
Andrzej Kutarski

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