Minimizing right ventricular pacing in sinus node disease: Sometimes the cure is worse than the disease

World Journal of Clinical Cases
Elia De MariaStefano Cappelli

Abstract

Traditional right ventricular (RV) apical pacing has been associated with heart failure, atrial fibrillation and increased mortality. To avoid the negative consequences of RV apical pacing different strategies have been developed, among these a series of pacing algorithms designed to minimize RV pacing. These functions are particularly useful when there is not the need for continuous RV pacing: intermittent atrio-ventricular blocks and, mainly, sinus node disease. However, in order to avoid RV pacing, the operational features of these algorithms may lead to adverse (often under-appreciated) consequences in some patients. We describe a case of a patient with sinus node disease, in whom right atrial only pacing involved long atrio-ventricular delay to allow intrinsic ventricular conduction, which led to symptomatic hypotension that could be overcome only by "forcing" also right ventricular apical pacing. We subsequently discuss this case in the context of current available literature.

References

Aug 1, 1990·The American Journal of Physiology·F W PrinzenR S Reneman
Jun 30, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Brian OlshanskyUNKNOWN INTRINSIC RV Study Investigators
May 11, 2010·The American Journal of Cardiology·Oscar CanoJosé Olagüe
Feb 9, 2011·European Heart Journal·Jens Cosedis NielsenUNKNOWN DANPACE Investigators
Jul 30, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Avi ShimonyGuy Amit
Jul 28, 2012·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Philippe MaboDaniel Gras
Aug 18, 2012·Pacing and Clinical Electrophysiology : PACE·Hoong Sern Lim
Jun 12, 2013·Circulation·Panos E VardasEmmanuel M Kanoupakis

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiac Conduction System

The cardiac conduction system is a specialized tract of myocardial cells responsible for maintaining normal cardiac rhythm. Discover the latest research on the cardiac conduction system here.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.