Upgrading from Right Ventricular Apical Pacing to Biventricular Pacing

  • M. H. Schoenfeld
Conference paper


It has been estimated that approximately 5% of the population worldwide suffers from congestive heart failure, of whom up to 30% may also have ventricular dyssynchrony resulting from intraventricular conduction delay [1, 2]. Recent work has demonstrated that biventricular pacing may be undertaken to achieve cardiac resynchronization, with resulting improvement in acute hemo-dynamics [3,4] and sustained amelioration of heart failure symptoms [5–7]. A recent meta-analysis also indicates that cardiac resynchronization reduces mortality from progressive heart failure in patients with symptomatic impairment in left ventricular function [8], and recently reported late-breaking trials from the COMPANION investigators, as yet unpublished, substantiate this impression [9]. What remains unclear is the prevalence of symptomatic heart failure in patients with ventricular dyssynchrony due to right ventricular apical pacing, and whether revision to biventricular pacing in these patients will afford symptomatic relief and/or improved survival. It is the purpose of this chapter to assess the role of cardiac resynchronization in patients with paced rhythm from the right ventricular apex.


Left Bundle Branch Block Ventricular Outflow Tract Ventricular Pace Chronic Atrial Fibrillation Biventricular Pace 
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Copyright information

© Springer-Verlag Italia 2004

Authors and Affiliations

  • M. H. Schoenfeld
    • 1
  1. 1.Yale University School of MedicineCardiac Electrophysiology and Pacer Laboratory, Hospital of Saint RaphaelNew HavenUSA

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