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المستخلص
Clinical rrials in patients with pacemakers for sinus node dysfunction or atrioventricular block (AVB) and implantable cardioverter-defibrillators provide increasing evidence showing that desynchroniztion of ventricular electrical activation and contraction, induced by conventional right ventricular apex(RVA) pacing, is a serious threat for long-term cardiac morbidity and mortality.
The risk of heart failure is increased even in hearts with initially normal pump function and in case of part-time ventricular pacing.
These epidemiologic data fit with knowledge from decades of pathophysiological research, indicating that right ventricular (RV) pacing creates abnormal contraction, reduced pump function, hypertrophy , and ultrastructural abnormalities .