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Previous Volume 357:2637-2638 December 20, 2007 Number 25 Next

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To the Editor: Children with congenital complete atrioventricular block often require lifelong pacemaker therapy. Although such therapy restores a normal heart rate, it also results in dyssynchronous left ventricular activation and contraction and compromises left ventricular function.^1,2,3 These effects are most pronounced during right ventricular pacing, the predominant pacing site in children and adults. Eventually, heart failure develops in 6 to 7% of children who undergo long-term right ventricular pacing.²

The harmful effects of right ventricular pacing initiated the search for pacing modes that would maintain or restore synchronous activation — in other words, biventricular pacing and alternative single-site ventricular . . . [Full Text of this Article]

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