Left Septal or Deep Septal Pacing to Prevent Pacing-induced Cardiomyopathy

Left Septal or Deep Septal Pacing to Prevent Pacing-induced Cardiomyopathy

Multicenter randomized controlled trial which will include patients with left ventricular ejection fraction >50% requiring a first implant of a cardiac pacemaker with expected high pacing percentages.

Patients will be randomized 1:1 to right ventricular apical pacing vs left septal or deep septal pacing. The primary endpoint will be pacing-induced cardiomyopathy during the first year of follow-up.

Inclusion Criteria:

• First implant of a single-chamber or dual chamber pacemaker due to persistent bradycardia associated with high degree atrio-ventricular (AV) block (complete AV block or second degree type II AV block), with second-degree type I AV block (symptomatic or associated with intra-hisian or infra-hisian block), or with atrial fibrillation with symptomatic slow ventricular rate (<45lpm).
• LVEF>50% at echocardiography performed maximum 7 days before pacemaker implant.
• Informed consent signature.

Exclusion Criteria:

• Life expectancy <12 months
• Severe cardiac valvular abnormality requiring intervention
• Unstable Angina, Acute myocardial infarction, coronary revascularization, valvular surgery or valvular percutaneous intervention in the 90 days prior to pacemaker implant.
• Inclusion in another trial which may influence the results of this study.