Minimizingrightventricularpacinginsinusnodedisease:Sometimesthecureisworsethanthedisease
摘要: Traditionalrightventricular(RV)apicalpacinghasbeenassociatedwithheartfailure,atrialfibrillationandincreasedmortality.ToavoidthenegativeconsequencesofRVapicalpacingdifferentstrategieshavebeendeveloped,amongtheseaseriesofpacingalgorithmsdesignedtominimizeRVpacing.ThesefunctionsareparticularlyusefulwhenthereisnottheneedforcontinuousRVpacing:intermittentatrioventricularblocksand,mainly,sinusnodedisease.However,inordertoavoidRVpacing,theoperationalfeaturesofthesealgorithmsmayleadtoadverse(oftenunder-appreciated)consequencesinsomepatients.Wedescribeacaseofapatientwithsinusnodedisease,inwhomrightatrialonlypacinginvolvedlongatrio-ventriculardelaytoallowintrinsicventricularconduction,whichledtosymptomatichypotensionthatcouldbeovercomeonlybyforcingalsorightventricularapicalpacing.Wesubsequentlydiscussthiscaseinthecontextofcurrentavailableliterature. ...
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