{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:48:19Z","timestamp":1788407299111,"version":"build-2803163510"},"reference-count":51,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T00:00:00Z","timestamp":1669075200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>AIMS: Bradyarrhythmias are potentially life-threatening medical conditions. The most widespread treatment for slow rhythms is artificial ventricular pacing. From the inception of the idea of artificial pacing, ventricular leads were located in the apex of the right ventricle. Right ventricular apical pacing (RVAP) was thought to have a deteriorating effect on left ventricular systolic function. The aim of this study was to systematically assess results of randomized controlled trials to determine the effects of right ventricular apical pacing on left ventricular ejection fraction (LVEF). Methods: we systematically searched the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE databases for studies evaluating the influence of RVAP on LVEF. Pooled mean difference (MD) with a 95% confidence interval (CI) was estimated using a random effect model. Results: 14 randomized controlled trials (RCTs) comprising 885 patients were included. In our meta-analysis, RVAP was associated with statistically significant left ventricular systolic function impairment as measured by LVEF. The mean difference between LVEF at baseline and after intervention amounted to 3.35% (95% CI: 1.80\u20134.91). Conclusion: our meta-analysis confirms that right ventricular apical pacing is associated with progressive deterioration of left ventricular systolic function.<\/jats:p>","DOI":"10.3390\/jcm11236889","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T08:29:58Z","timestamp":1669105798000},"page":"6889","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Cardiomyopathy Associated with Right Ventricular Apical Pacing-Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Andrzej","family":"Osiecki","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases, Bielanski Hospital, Centre of Postgraduate Medical Education, Ceglowska 80 Street, 01-809 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wac\u0142aw","family":"Kochman","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Bielanski Hospital, Centre of Postgraduate Medical Education, Ceglowska 80 Street, 01-809 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus K.","family":"Witte","sequence":"additional","affiliation":[{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0736-0389","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Ma\u0144czak","sequence":"additional","affiliation":[{"name":"Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw, 1 Spartanska Street, 02-637 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4210-5279","authenticated-orcid":false,"given":"Robert","family":"Olszewski","sequence":"additional","affiliation":[{"name":"Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw, 1 Spartanska Street, 02-637 Warsaw, Poland"},{"name":"Department of Ultrasound, Institute of Fundamental Technological Research, Polish Academy of Sciences in Warsaw, 5B Pawinskiego Street, 02-106 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz","family":"Micha\u0142kiewicz","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Bielanski Hospital, Centre of Postgraduate Medical Education, Ceglowska 80 Street, 01-809 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1016\/j.hrthm.2014.05.040","article-title":"Incidence and predictors of right ventricular pacing-induced cardiomyopathy","volume":"11","author":"Khurshid","year":"2014","journal-title":"Heart Rhythm"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1540-8167.2007.01014.x","article-title":"New-Onset Heart Failure After Permanent Right Ventricular Apical Pacing in Patients with Acquired High-Grade Atrioventricular Block and Normal Left Ventricular Function","volume":"19","author":"Zhang","year":"2007","journal-title":"J. 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