In this study, the investigators will examine whether left ventricular pacing is superior to right ventricular apical pacing in preventing deterioration of left ventricular systolic function and cardiac remodeling in patients with bradycardia with high risk for development of pacing-induced heart failure.
In this prospective, we will randomly assign 98 patients who need permanent pacemaker due to complete atrioventricular block or sick sinus syndrome to receive left ventricular pacing (49 patients) or right ventricular apical pacing (49 patients). Patients will be paced with temporary pacemaker lead, and only those with paced QRS duration ≥185 ms will be enrolled. The primary endpoint is left ventricular ejection fraction measured by modified Simpson method at 12 months. The secondary end points include left ventricular systolic end-systolic and diastolic volume, LV strain, NYHA functional class, exercise performance (using treadmill test), quality of life (using SF-36v2), NT-proBNP at 12 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Seoul National University Bundang Hospital
Seongnam, South Korea
Seoul National University Hospital
Seoul, South Korea
Left ventricular ejection fraction (%) at 12 months
Measured by modified Simpson's method
Time frame: 12 months
Left ventricular end-systolic volume (ml) at 12 months
Measured by modified Simpson method
Time frame: 12 months
Left ventricular end-diastolic volume (ml) at 12 months
Measured by modified Simpson method
Time frame: 12 months
NYHA functional class
Time frame: 12 months
Functional capacity
measured by treadmill test
Time frame: 12 months
NT-proBNP
plasma level
Time frame: 12 months
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