Abstract

The potentially deleterious effects of conventional right ventricular apical (RVA) pacing have been recognized increasingly, with particular emphasis on promoting cardiac dyssynchrony.1 Large-scale evaluations have demonstrated that RVA pacing may contribute to poor clinical outcomes. Increased RVA pacing predicted death or congestive heart failure (CHF) hospitalization in patients with implantable cardioverter-defibrillators with baseline depressed left ventricular (LV) function in the Dual Chamber and VVI Implantable Defibrillator trial2,3 and Multicenter Automatic Defibrillator Implantation Trial II4 as well as in patients with pacemakers examined in the Danish study5 and Mode Selection Trial.

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