October 2018 Br J Cardiol 2018;25(suppl 3):S25–S29 doi:10.5837/bjc.2018.s16
Daniel Keene, Matthew Shun-Shin, Ahran Arnold, Zachary Whinnett
Current landscape For 60 years, right ventricular pacing has been the standard of care for patients with bradycardia who require cardiac pacing. However, while right ventricular pacing is very effective in preventing bradycardia, it produces non-physiological ventricular activation. The ventricular activation wave-front proceeds slowly via cell-to-cell conduction from the pacing site within the right ventricle, resulting in electrical dyssynchrony with delayed left ventricular activation. This non-physiological activation may lead to left ventricular impairment.1,2 Furthermore, right ventricular pacing, when delivered to patients with ventric
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