The downside of right ventricular apical pacing

Andrew Brenyo*, Ilan Goldenberg, Alon Barsheshet

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


The right ventricular (RV) apex has been the standard pacing site since the development of implantable pacemaker technology. Although RV pacing was initially only utilized for the treatment of severe bradyarrhythmias usually due to complete heart block, today the indications for and implantation of RV pacing devices is dramatically larger. Recently, the adverse effects of chronic RV apical pacing have been described including an increased risk of heart failure and death. This review details the detrimental effects of RV apical pacing and their shared hemodynamic pathophysiology. In particular, the role of RV apical pacing induced ventricular dyssynchrony is highlighted with a specific focus on differential outcome based upon QRS morphology at implant.

Original languageEnglish
Pages (from-to)102-113
Number of pages12
JournalIndian Pacing and Electrophysiology Journal
Issue number3
StatePublished - 2012
Externally publishedYes


  • Down side
  • Right ventricular pacing


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