{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T17:10:40Z","timestamp":1770570640598,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2006,9,14]],"date-time":"2006-09-14T00:00:00Z","timestamp":1158192000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2006,9]]},"abstract":"<jats:p> <jats:italic>\n            <jats:bold>Background:<\/jats:bold> Asynchronous electrical activation induced by right ventricular apex (RVA) pacing can cause various abnormalities in left ventricular (LV) function, particularly in the context of severe LV dysfunction or structural heart disease. However, the effect of RVA pacing in patients with normal LV and right ventricular (RV) function has not been fully elucidated. The aim of this study was to characterize the effects of RVA pacing on LV and RV function by assessing isovolumic contraction time and isovolumic relaxation time divided by ejection time (Tei index) and by assessing changes in plasma brain natriuretic peptide (BNP).<\/jats:italic> <\/jats:p><jats:p> <jats:italic>\n            <jats:bold>Methods:<\/jats:bold> Doppler echocardiographic study and BNP measurements were performed at follow\u2010up (mean intervals from pacemaker implantation, 44 \u00b1 75 months) in 76 patients with dual chamber pacemakers (sick sinus syndrome, n = 30; atrioventricular block, n = 46) without structural heart disease. Patients were classified based on frequency of RVA pacing, as determined by 24\u2010hour ambulatory electrocardiogram (ECG) that was recorded just before echocardiographic study: pacing group, n = 46 patients with RVA pacing \u226550% of the time, percentage of ventricular paced 100 \u00b1 2%; sensing group, n = 30, patients with RVA pacing &lt;50% of the time, percentage of ventricular paced 3 \u00b1 6%.<\/jats:italic> <\/jats:p><jats:p> <jats:italic>\n            <jats:bold>Results:<\/jats:bold> There was no significant difference in mean heart rate derived from 24\u2010hour ambulatory ECG recordings when comparing the two groups (66 \u00b1 11 bpm vs 69 \u00b1 8 bpm). LV Tei index was significantly higher in pacing group than in sensing group (0.67 \u00b1 0.17 vs 0.45 \u00b1 0.09, P &lt; 0.0001), and the RV Tei index was significantly higher in pacing group than in sensing group (0.34 \u00b1 0.19 vs 0.25 \u00b1 0.09, P = 0.011). Furthermore, BNP levels were significantly higher in pacing group than in sensing group (40 \u00b1 47 pg\/mL vs 18 \u00b1 11 pg\/mL, P = 0.017). With the exception of LV diastolic dimension (49 \u00b1 5 mm vs 45 \u00b1 5 mm, P = 0.012), there were no significant differences in other echocardiographic parameters, including left atrium (LA) diameter (35 \u00b1 8 mm vs 34 \u00b15 mm), LA volume (51 \u00b1 27 cm<jats:sup>3<\/jats:sup> vs 40 \u00b1 21 cm<jats:sup>3<\/jats:sup>), LV systolic dimension (30 \u00b1 6 mm vs 29 \u00b1 7 mm), or ejection fraction (66 \u00b1 9% vs 63 \u00b1 11%), when comparing the two groups.<\/jats:italic> <\/jats:p><jats:p> <jats:italic>\n            <jats:bold>Conclusions:<\/jats:bold> These findings suggest that the increase of LV and RV Tei index, LVDd, and BNP are highly correlated with the frequency of the RVA pacing in patients with dual chamber pacemakers.<\/jats:italic> 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