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Cardiomyopathy Associated with Right Ventricular Apical Pacing-Systematic Review and Meta-Analysis

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 23, Pages -

Publisher

MDPI
DOI: 10.3390/jcm11236889

Keywords

artificial pacing; right ventricular pacing; left ventricular systolic function; heart failure

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Right ventricular apical pacing is associated with progressive deterioration of left ventricular systolic function.
AIMS: Bradyarrhythmias are potentially life-threatening medical conditions. The most widespread treatment for slow rhythms is artificial ventricular pacing. From the inception of the idea of artificial pacing, ventricular leads were located in the apex of the right ventricle. Right ventricular apical pacing (RVAP) was thought to have a deteriorating effect on left ventricular systolic function. The aim of this study was to systematically assess results of randomized controlled trials to determine the effects of right ventricular apical pacing on left ventricular ejection fraction (LVEF). Methods: we systematically searched the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE databases for studies evaluating the influence of RVAP on LVEF. Pooled mean difference (MD) with a 95% confidence interval (CI) was estimated using a random effect model. Results: 14 randomized controlled trials (RCTs) comprising 885 patients were included. In our meta-analysis, RVAP was associated with statistically significant left ventricular systolic function impairment as measured by LVEF. The mean difference between LVEF at baseline and after intervention amounted to 3.35% (95% CI: 1.80-4.91). Conclusion: our meta-analysis confirms that right ventricular apical pacing is associated with progressive deterioration of left ventricular systolic function.

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