UMEM Educational Pearls

Pacing Atrioventricular Block

 - Atrioventricular (AV) block is classically treated with restoration of heart rate via right ventricular pacing, however high rates of right ventricular pacing is associated w/ left  ventricular systolic dysfunction  

- A recent multi-center randomized control trial (RCT) assessed the efficacy of right vs biventricular pacing in heart failure w/ AV block [BLOCK HF Trial]

- Primary outcomes of: morbidity, mortality, and adverse left ventricular remodeling were shown to be significantly lower in biventricular vs right ventricular pacing 

- In patients with a high rate of pacing and/or an  abnormally low left ventricular ejection fraction biventricular pacing may be more advantageous than conventional right ventricular pacing

 

References

Curtis A.B., Worley S.J., Adamson P.B.,et al: Biventricular pacing for atrioventricular block and systolic dysfunction. N Engl J Med 2013; 368: 1585-1593