Biventricular Pacing for Atrioventricular Block and Systolic Dysfunction

To the Editor: In the Biventricular versus Right Ventricular Pacing in Heart Failure Patients with Atrioventricular Block (BLOCK HF) study by Curtis et al. (April 25 issue), 1 the outcomes with right ventricular and biventricular pacing were compared in patients with atrioventricular block and left ventricular dysfunction. However, we find it hard to alter current practice because of the makeup of the control group. In light of the findings in the Dual Chamber and VVI Implantable Defibrillator (DAVID) trial, 2 the current standard of care is to minimize pacing of the right ventricle only in patients with left ventricular dysfunction and first-degree . . .