DURATION OF THE QRS COMPLEX IN SEPTAL AND APICAL RIGHTVENTRICULAR PACING

Abstract

Introduction: Right ventricular pacing is a primary method for treating bradyarrhythmias. Chronic pacing of the right ventricle is associated with systolic and diastolic dysfunction in certain patients. The duration of the QRS complex and the accompanying dyssynchrony are considered key predictors for the development of pacemaker-induced cardiomyopathy (PICM). Objectives: The aim of this study is to compare QRSd (the difference between the duration of the native preprocedural and paced post-procedural QRS) in apical and septal lead positioning. Material and Methods: In this retrospective study, ten consecutive patients with right ventricular apical pacing and ten consecutive patients with right ventricular septal pacing were compared. Using pre- and post-procedural recordings from a 12-lead ECG, the duration of the widest QRS complex from all leads was analyzed for each patient. The QRS complex recorded pre-procedurally (QRSb) served as a reference, and the paced QRS complexes (QRSp) were compared against it, with each patient with right ventricular apical stimulation (67.1 ± 11.1 ms vs. 37.3 ± 22.8 ms, p < 0.05) compared to the septal stimulation group. Conclusion: Right ventricular septal pacing is associated with a significantly shorter duration of the paced QRS complex.