Deep Septal Pacing for Pacemaker-Induced Cardiomyopathy

• Published in: Pacing and clinical electrophysiology 2024-12
• Main Authors: Mercé, Jordi, Anguera, Ignasi, Rodríguez, Marcos, Faga, Valentina, Rodríguez, Julián, Dallaglio, Paolo D, Antonio, Rodolfo San, Marco, Andrea Di
• Format: Article
• Language: English
• ISSN: 1540-8159; 1540-8159
• DOI: 10.1111/pace.15135

Right ventricular (RV) pacing can impair left ventricular function and cause heart failure, known as pacing-induced cardiomyopathy (PICM). Upgrade to cardiac resynchronization (CRT) is its usual treatment; recently left bundle branch area pacing (LBBAP) has emerged as a potential alternative. Deep septal pacing (DSP), a simplified alternative to LBBAP, is still able to achieve narrower paced QRS than during conventional RV pacing. The aim of this study was to assess the effect of DSP in a cohort of patients with PICM. Consecutive patients diagnosed with PICM were included. The aim was to upgrade patients to DSP. The procedure was considered successful if a paced QRS duration ≤140 ms was obtained, in the absence of a terminal R wave in V1. Twelve patients were included. The mean baseline LVEF was 33% (SD 4%), and the mean percentage of RV pacing was 99% (SD 1%). All patients had symptomatic heart failure. The mean paced QRS duration was 172 ms (SD 14 ms) with RV pacing, and 130 ms (SD 7 ms) with DSP (mean difference 42 ms, p