Right Ventricular Pacing and Cardiac Resynchronization Devices.

Long-term right ventricular pacing is associated with electrical and mechanical dyssynchrony and ultimately development of pacing-induced cardiomyopathy (PICM) in a subset of patients. Patients with a high degree of pacing burden and reduced left ventricular (LV) function prior to pacemaker implantation are at the greatest risk for developing PICM. Cardiac resynchronization therapy (CRT) has an established role in the treatment of patients with LV systolic heart failure and intraventricular delay and has been used to successfully treat PICM. This review evaluates predictors for PICM, as well as highlights the role for CRT in prevention and treatment in high risk patients.