Table 1:
Select Trials of RVA and RVNA Pacing
| Author | Trial Design | RVA (n) | RVNA (n) | RVNA Site | Follow-up | Important Characteristics | Outcome(s) | ||
|---|---|---|---|---|---|---|---|---|---|
| Zou et al.2 | Retrospective/Parallel | 42 | 38 | RVOT | 2 years | • | All patients: CHB with normal ejection fraction | • | RVOT septal pacing was associated with improved atrial electrical activity in patients with normal cardiac function |
| Stambler et al.22 | Parallel | 37 | 43 | RVOT | 3 months | • | All patients: HF, LVEF < 40%, 64% post-AVN ablation | • | Dual-site RV pacing shortens QRS duration but does not improve QOL or clinical outcomes in comparison with RVA pacing |
| Kaye et al.24 | Parallel | 120 | 120 | High-septal | 2 years | • | All patients: high-grade AVB, > 90% ventricular pacing, preserved LVEF | • | No difference in LVEF, mortality, HFH, or AF burden was found |
| Kypta et al.29 | Parallel | 45 | 53 | Mid-septum or RVOT | 3 months | • | All patients: AVB, LVEF < 40%, no HF, MI, AF | • | No difference in BNP, LVEF, or exercise capacity was found |
| Dabrowska-Kugacka et al.30 | Parallel | 66 | 56 | RVOT | 10 years | • | 17 patients: SSS, 80 patients: AVB, 24 patients: AF, LVEF > 40% | • | No difference in all-cause or cardiovascular mortality was found |
| Gong et al.31 | Parallel | 44 | 46 | RVOT | 1 year | • | All patients: symptomatic AVB, LVEF > 50% | • | RVA pacing had more intra-ventricular systolic dyssynchrony than did RVNA pacing, though LVEF and left ventricular volumes were similar between the two |
| Cano et al.32 | Parallel | 28 | 32 | Mid-septum | 1 year | • | 3 patients: SSS | • | RVA pacing had longer QRSd and more intra-ventricular dyssynchrony in comparison with RVNA pacing |
| • | 57 patients: AVB, LVEF > 50% | • | BNP levels, NYHA functional class, and QOL were similar between the two | ||||||
| Leong et al.33 | Parallel | 26 | 32 | RVOT | 11–53 months | • | 26 patients: SSS | • | RVA pacing had longer QRSd and intra-ventricular dyssynchrony |
| • | 32 patients: symptomatic AVB | • | Left atrial volume was significantly lower with RVNA pacing | ||||||
n: number of patients; RVA: right ventricle apical; RVNA: right ventricle nonapical; RVOT: right ventricular outflow tract; CHB: complete heart block; HF: heart failure; LVEF: left ventricular ejection fraction; SSS: sick sinus syndrome; AVN: atrioventricular node; NYHA: New York Heart Association; QOL: quality of life; AVB: atrioventricular block; BNP: brain natriuretic peptide; MI: myocardial infarction; AF: atrial fibrillation; QRSd: QRS duration; HFH: heart failure hospitalizations.