{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:47:48Z","timestamp":1781650068441,"version":"3.54.5"},"reference-count":24,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["CH\/09\/002"],"award-info":[{"award-number":["CH\/09\/002"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/14\/78\/31020"],"award-info":[{"award-number":["FS\/14\/78\/31020"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2018,12,1]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Optimal right ventricular lead placement remains controversial. Large studies investigating the safety and long-term prognosis of apical and septal right ventricular lead placement have been lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Consecutive patients undergoing pacemaker insertion for high-degree atrioventricular block at Edinburgh Heart Centre were investigated. Periprocedural 30-day complications were defined (infection\/bleeding\/pneumothorax\/tamponade\/lead displacement). Long-term clinical outcomes were obtained from the General Register of Scotland and electronic medical records. The primary endpoint was a composite of all-cause mortality, new heart failure, hospitalisation for a major cardiovascular event, as per the <jats:underline>CA<\/jats:underline>rdiac <jats:underline>RE<\/jats:underline>synchronization in <jats:underline>H<\/jats:underline>eart <jats:underline>F<\/jats:underline>ailure trial. Secondary endpoints were all-cause mortality, new heart failure and their composite.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>820 patients were included, 204 (25%) paced from the septum and 616 (75%) from the apex. All baseline variables were similar with the exception of age (septal: 73.2\u00b11.1 vs apical: 76.9\u00b10.5 years, p&lt;0.001). Procedure duration (58\u00b123 vs 55\u00b125\u2009min, p=0.3), complication rates (18 (8.8) vs 46 (7.5)%, p=0.5) and postimplant QRS duration (152 (23) vs 154 (27) ms, p=0.4) were similar. After 1041 days (IQR 564), 278 patients met the primary endpoint, with no difference between the septal and apical groups in unadjusted (HR 0.86 (95% CIs 0.64 to 1.15)) or multivariable analysis correcting for age, gender and comorbidity (HR 0.97 (95% CI 0.72 to 1.30)). Similarly, no differences were observed in the secondary endpoints.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This large real-world cohort of patients undergoing right ventricular lead placement in the septum or apex demonstrated no difference in procedural complications nor long-term clinical outcomes. Both pacing strategies appear reasonable in routine practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2018-000962","type":"journal-article","created":{"date-parts":[[2019,2,9]],"date-time":"2019-02-09T10:45:12Z","timestamp":1549709112000},"page":"e000962","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Complications and prognosis of patients undergoing apical or septal right ventricular pacing"],"prefix":"10.1136","volume":"6","author":[{"given":"Nick B","family":"Spath","sequence":"first","affiliation":[{"name":"BHF\/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin","family":"Wang","sequence":"additional","affiliation":[{"name":"BHF\/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sowmya","family":"Venkatasumbramanian","sequence":"additional","affiliation":[{"name":"Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Fersia","sequence":"additional","affiliation":[{"name":"Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E","family":"Newby","sequence":"additional","affiliation":[{"name":"BHF\/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK"},{"name":"Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris CE","family":"Lang","sequence":"additional","affiliation":[{"name":"Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil R","family":"Grubb","sequence":"additional","affiliation":[{"name":"Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc R","family":"Dweck","sequence":"additional","affiliation":[{"name":"BHF\/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK"},{"name":"Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,2,9]]},"reference":[{"issue":"suppl_2","key":"2025081711015013000_6.1.e000962.1","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1093\/europace\/eux258","article-title":"A Decade of Information on the Use of Cardiac Implantable Electronic Devices and Interventional Electrophysiological Procedures in the European Society of Cardiology Countries: 2017 Report from the European Heart Rhythm Association","volume":"19","author":"Raatikainen","year":"2017","journal-title":"Europace"},{"key":"2025081711015013000_6.1.e000962.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2004.00565.x"},{"key":"2025081711015013000_6.1.e000962.3","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht150"},{"key":"2025081711015013000_6.1.e000962.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2006.00338.x"},{"key":"2025081711015013000_6.1.e000962.5","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.66.6.443"},{"key":"2025081711015013000_6.1.e000962.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-5273(99)00077-7"},{"key":"2025081711015013000_6.1.e000962.7","doi-asserted-by":"publisher","DOI":"10.1067\/mje.2001.115655"},{"key":"2025081711015013000_6.1.e000962.8","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.79.4.845"},{"key":"2025081711015013000_6.1.e000962.9","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2005.50038.x"},{"key":"2025081711015013000_6.1.e000962.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02169-1"},{"key":"2025081711015013000_6.1.e000962.11","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.98.6.588"},{"key":"2025081711015013000_6.1.e000962.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)01096-2"},{"key":"2025081711015013000_6.1.e000962.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.11.044"},{"key":"2025081711015013000_6.1.e000962.14","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu304"},{"key":"2025081711015013000_6.1.e000962.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.05.005"},{"key":"2025081711015013000_6.1.e000962.16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.117.006107"},{"key":"2025081711015013000_6.1.e000962.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050496"},{"key":"2025081711015013000_6.1.e000962.18","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur251"},{"key":"2025081711015013000_6.1.e000962.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.05.007"},{"key":"2025081711015013000_6.1.e000962.20","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht511"},{"key":"2025081711015013000_6.1.e000962.21","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1111\/pace.12817","article-title":"Imaging and Right Ventricular Pacing Lead Position: A Comparison of CT, MRI, and Echocardiography","volume":"39","author":"Moore","year":"2016","journal-title":"Pacing Clin Electrophysiol"},{"key":"2025081711015013000_6.1.e000962.22","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eus313"},{"key":"2025081711015013000_6.1.e000962.23","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq038"},{"key":"2025081711015013000_6.1.e000962.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.048"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2018-000962","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T18:01:56Z","timestamp":1755453716000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2018-000962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,2,9]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/openhrt-2018-000962"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2018-000962","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}