Alternatives to right ventricular pacing in patients with atrioventricular block: can we prevent pacing-induced cardiomyopathy?

IF 2.5 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Expert Review of Cardiovascular Therapy Pub Date : 2026-01-01 Epub Date: 2026-01-27 DOI:10.1080/14779072.2026.2621679

Mert Dogan, Ugur Canpolat

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引用次数: 0

Abstract

Introduction: Right ventricular apical pacing (RVAP) has been a standard treatment for patients experiencing symptomatic advanced atrioventricular (AV) block. However, due to electrical and subsequent mechanical dyssynchrony, RVAP might lead to pacing-induced cardiomyopathy (PICM). Various predisposing risk factors for PICM have been identified.

Areas covered: This review, based on a literature search of PubMed and Scopus databases (up to April 2025), focuses on alternative pacing strategies, including conduction system pacing (CSP) and biventricular pacing (BiVP), to reduce PICM.

Expert opinion: Implementing pacing strategies that encourage physiological ventricular activation, like CSP and BiVP, can greatly diminish the risk of PICM in patients with AV block. Implementing alternative pacing strategies necessitates careful patient selection and consideration of individual anatomical and clinical factors. A team-based approach should be utilized to identify the most suitable pacing method for each patient, with the goal of optimizing cardiac function and reducing the risk of PICM.

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房室传导阻滞患者右心室起搏的替代方案：我们能预防起搏诱发的心肌病吗？

导读：右室心尖起搏（RVAP）已成为有症状的晚期房室传导阻滞患者的标准治疗方法。然而，由于电和随后的机械不同步，RVAP可能导致起搏性心肌病（PICM）。PICM的各种易感危险因素已被确定。涵盖领域：本综述基于PubMed和Scopus数据库的文献检索（截至2025年4月），重点关注可选择的起搏策略，包括传导系统起搏（CSP）和双心室起搏（BiVP），以减少PICM。专家意见：实施促进生理心室激活的起搏策略，如CSP和BiVP，可以大大降低房室传导阻滞患者发生PICM的风险。实施替代起搏策略需要仔细选择患者并考虑个体解剖和临床因素。应采用以团队为基础的方法，为每位患者确定最合适的起搏方法，以优化心功能并降低PICM的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

0.00%

发文量

期刊介绍： Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.