Right ventricular outflow tract septal pacing is superior to right ventricular apical pacing

Background-the effects of right ventricular apical pacing (rvap) and right ventricular outflow tract (rvot) septal pacing on atrial and ventricular electrophysiology have not been thoroughly compared. methods and results--to identify a more favorable pacing strategy with fewer adverse effects,80 patients who had complete atrioventricular block with normal cardiac function and who were treated with either rvap (n=42) or rvot septal pacing (n=38) were recruited after an average of 2 years of follow-up. the data from electrocardiography and echocardiography performed before pacemaker implantation and at the end of follow-up were collected. the patients in the rvot septal pacing and rvap groups showed similar demographic and clinical characteristics before pacing treatments. after a mean follow-up of 2 years,the final maximum p-wave duration; p-wave dispersion; q-,r-,and s-wave complex duration; left atrial volume index; left ventricular endsystolic diameter; ratio of transmitral early diastolic filling velocity to mitral annular early diastolic velocity; and interventricular mechanical delay in the rvot septal pacing group were significantly less than those in the rvap group (p<0.05). the final left ventricular ejection fraction of the rvot septal pacing group was significantly higher than that of the rvap group (p<0.05). © 2015 the authors.