Objective To evaluate the effectiveness of right ventricular septum (RVS) pacing for the treatment of arrhythmia.
Methods We searched the electronic bibliographic databases, including Cochrane Central Register of Controlled Trials (Issue 1, 2010), PubMed (1994∼2010.5). EMBASE (1994∼2010.5), CNKI (1994∼2010.5), VIP (1994∼2010.5), Wanfang database (1994∼2010.5) to assemble the randomised controlled trials (RCTs) of RVS Pacing compared with right ventricular apical (RVA) pacing. Two reviewers evaluated the quality of included studies based on the Handbook 5.0.2 and extracted data independently. Meta-analysis was performed by RevMan 5.0 software.
Results 35 RCTs involving 2054 patients were included. The results of meta-analysis showed: compared with the RVA pacing, RVS pacing could significantly reduce the QRS wave duration (MD=−0.05, 95% CI −0.07 to −0.02), significantly increase the left ventricular ejection fraction of 3 months and 18 months after operation (MD=7.10, 95% CI 3.03 to 11.17); (MD=7.44, 95% CI 5.46 to 9.42). 3 months later, there was no significant difference between the two groups with regard to pacing threshold (MD=−13.88, 95% CI −29.75 to 2.00), Compared with RVA, RVS was associated with a significant reduction in threshold perception current (MD=−0.73, 95% CI −29.75 to −0.12) and impedance (MD=−75.12, 95% CI −35.53 to −14.71).
Conclusion RVS pacing can give patients a good physiological state which is more consistent with biventricular electric conduction, and lead to haemodynamic improvement. RVS pacing might be expected to become a preferred site of ventricular pacing.