EFFECT OF RIGHT VENTRICULAR APICAL PACING ON LEFT VENTRICULAR FUNCTIONS

Permanent cardiac pacing has evolved its current application with the recent advances in low-threshold lead technology and a reduction in generator size. epicardial or transvenous ventricular pacing leads have traditionally been affixed to the right ventricular (RV)apex, resulting in asynchronous patterns of right and left ventricular (LV)contraction and relaxation. Other investigators have demonstrated reversible LV functional abnormalities with short-term RV apical pacing. Although cellular and subcellular abnormalities have been shown to occur after long-term RV apical pacing Chronic dyssynchronous ventricular contraction lead to irreversible LV dysfunction remains speculative.A depressed left ventricular (LV) ejection fraction (EF) has an important independent effect on the risk of future adverse cardiac events, suh as sudden cardiac death , congestive heart failure, and cardiovascular mortality. Subsequent significant changes in LVEF also carry major prognostic implications.