March 3, 2026Open Access

Impact of Right Ventricular Pacing Sites on Right Ventricular Function: Systematic Review and Meta-analysis

Key Points

Right ventricular function declines with specific pacing sites, particularly apical pacing, negatively impacting echocardiographic measures.
Apical pacing resulted in the greatest reductions in S' and various echocardiographic parameters in the review.

Structured PICO

Does the site of right ventricular pacing (e.g., apical vs LBBAP) impact right ventricular function?

Population

Patients undergoing right ventricular pacing

Intervention

Right ventricular pacing at different sites (including apical pacing and left bundle branch area pacing [LBBAP])

Comparator

Comparison between different pacing sites

Outcome

Right ventricular function (echocardiographic parameters including S')surrogate

Left bundle branch area pacing (LBBAP) preserves right ventricular echocardiographic function better than traditional apical pacing.

Abstract

RV pacing is associated with significant reductions in S' and notable effects on other echocardiographic parameters, with heterogeneity largely driven by the site of pacing. Apical pacing had the most detrimental effects across multiple parameters, whereas LBBAP was generally associated with better outcomes. Further studies are needed to address residual heterogeneity and examine additional covariates.

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Cite This Study

DeAngelo et al. (Tue,) studied this question.

synapsesocial.com/papers/69a75ff8c6e9836116a2c592 https://doi.org/https://doi.org/10.15420/aer.2025.17

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