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

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 paci...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical medicine 2022-11, Vol.11 (23), p.6889
Main Authors: Osiecki, Andrzej, Kochman, Wacław, Witte, Klaus K, Mańczak, Małgorzata, Olszewski, Robert, Michałkiewicz, Dariusz
Format: Article
Language:English
Subjects:
Bias
Cardiomyopathy
Cardiovascular disease
Clinical medicine
Electrodes
Meta-analysis
Pacemakers
Patients
Sensitivity analysis
Sinuses
Systematic Review
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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). 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. 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). our meta-analysis confirms that right ventricular apical pacing is associated with progressive deterioration of left ventricular systolic function.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11236889