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Pacing at moderately higher heart rates improves myocardial relaxation and decreases filling pressures in patients with heart failure with preserved ejection fraction or isolated diastolic dysfunction. Conduction system or biventricular pacing that optimizes ventricular synchrony avoids deleterious effects that could be seen with a high burden of right ventricular pacing. ECG = electrocardiogram; LV = left ventricle; RV = right ventricle.
