PACE: A trial that challenges dogma

Nov 24, 2009 13:50 EST

This well designed trial sought to find out whether placing a right ventricular lead at the apex--as per standard pacing procedure--leads to adverse cardiac remodeling and hence could promote heart failure and cardiac death. The results not only challenge dogma but pose a dilemma for clinical practice. How do you interpret the PACE trial? What are your thoughts?

See:

PACE: BiV pacing protects against RV pacing's adverse ventricular effects in randomized trial

Cheuk-Man Y, Yat-Sun Chan J, Zhang Q, et al. Biventricular pacing in patients with bradycardia and normal ejection fraction. N Engl J Med 2009; DOI: 10.1056/NEJMoa0907555. Available at: http://www.nejm.org.