Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2015; 3(3): 206-209
Published online Mar 16, 2015. doi: 10.12998/wjcc.v3.i3.206
Minimizing right ventricular pacing in sinus node disease: Sometimes the cure is worse than the disease
Elia De Maria, Alina Olaru, Stefano Cappelli
Elia De Maria, Stefano Cappelli, Cardiology Unit, Ramazzini Hospital, 41012 Carpi (Modena), Italy
Alina Olaru, Department of Cardiovascular Medicine, University of Modena ad Reggio Emilia, 41100 Modena, Italy
Author contributions: De Maria E contributed to the conception and design of the work, drafting the article, final approval; Olaru A and Cappelli S contributed to the drafting and critical revision of the work, final approval.
Conflict-of-interest: None to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Elia De Maria, MD, Cardiology Unit, Ramazzini Hospital, Via Molinari 1, 41012 Carpi (Modena), Italy. e.demaria@inwind.it
Telephone: +39-05-9659320 Fax: +39-05-9659387
Received: October 23, 2014
Peer-review started: October 24, 2014
First decision: December 12, 2014
Revised: December 28, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: March 16, 2015
Processing time: 141 Days and 14.4 Hours
Core Tip

Core tip: Right ventricular apical pacing has been associated with worse outcome so a series of pacing algorithms have been designed to minimize it. However the operational features of these algorithms may lead to adverse consequences in some patients. We describe a case of a patient with sinus node disease, in whom right atrial only pacing involved long atrio-ventricular delay to allow intrinsic ventricular conduction, which led to symptomatic hypotension that could be overcome only by “forcing” right ventricular apical pacing. We subsequently discuss this case in the context of current available literature.