Is There Any Advantage For Dual Chamber AV Sequential Pacing?
|Is there any advantage for dual chamber AV sequential pacing?
In dual chamber AV sequential pacing, right atrium is paced initially and the right ventricle paced after a delay. This facilitates ventricular filling by atrial contraction. This is more important in those with stiff ventricles. Normally atrial contraction contributes to only about 15% of ventricular filling. But in a ventricle with difficulty in relaxing, atrial contribution may be as high as 30%.
Dual chamber pacemaker is naturally more expensive and the battery life is lesser. Pacing the right ventricle has a disadvantage of producing left ventricular dyssynchrony and a potentially higher risk of heart failure in the long run. Hence now there is a trend to pace in the region of the left bundle branch to avoid this, though it is technically more challenging.