Introduction: It is not clear if RVA pacing is acceptable or not.
Methods: We enrolled 230 patients who underwent permanent pacemaker implantation and were followed for at least one-year. Of these patients, we included those paced from the RVA (223 pts) with the following indications; atrioventricular block (AVB): 122, sick sinus syndrome (SSS): 86, atrial fibrillation and bradycardia (AFB): 12, and reflex syncope (RS): 3. If a patient’s RV pacing ratio was over 40%, we used ultrasound cardiography to evaluate the impact on LVEF using a 50% cut-off.
Results: Five patients (AVB: 4 and AFB: 1) were excluded due to an LVEF under 50% before implantation. Final qualifying cases for analysis included 82 with AVB, 2 with SSS, and 11 with AFB. The patients whose LVEF decreased below 50% during follow up were 14 AVB cases, 0 SSS cases, and 2 AFB cases resulting in a composite of 16.8%.
Conclusions: Lead placement at the RVA seems acceptable. Therefore, RVA implantation can be thought as a base strategy and if necessary CRT-P upgrade is now common and easy to perform.