High-Septal Pacing Reduces Ventricular Electrical Remodeling and Proarrhythmia in Chronic Atrioventricular Block Dogs

High-Septal Pacing Reduces Ventricular Electric Remodeling and Proarrhythmia in Chronic Atrioventricular Block Dogs Stephan K. G. Winckels, Morten B. Thomsen, Peter Oosterhoff, Avram Oros, Jet D. M. Beekman, Nico J. M. Attevelt, Leo Kretzers, Marc A. Vos The importance of the ventricular activation sequence on the magnitude of ventricular remodeling is investigated in the dog model of chronic atrioventricular block. For this purpose, atrioventricular block dogs that were paced from the high interventricular septum were compared to dogs with uncontrolled idioventricular rhythm. After 4 weeks of similar bradycardia, electrical remodeling and proarrhythmic response to dofetilide were less in the high-septal pacing group, suggesting that the pattern of ventricular activation does play a larger role in electric remodeling than previously assumed.