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RV Septal Pacing: Should We Go for It?

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Dr John Roshan Jacob ,Vellore    19 December 2017

  1. Pacing from RV septum is associated with a narrower QRS duration and the ventricular activation is closer to the normal physiology whencompared to RV apical pacing.
  2. There are studies that show RV septal pacing to be superior to RV apical pacing in causing less BP variation and less LV dysfunction.
  3. However, there are also studies, like the PROTECT PACE that show that it is not superior to RV apical pacing. Besides, RV septal pacing is associated with longer procedure and fluoroscopy time. It is still unclear if RV septal pacing is superior to RV apical pacing and long-term studies with larger patient numbers are required.
  4. RV septal pacing currently has a role in patients who have a peripheral atrioventricular block; for whom His bundle or para-hisian pacing will not result in a narrow QRS.

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