Heart failure & cardiomyopathies
Temporal change in right ventricular pacing ratio and its association with cardiac function and arrhythmia: A linear mixed-effects model analysis
Authors' conclusion
Progressive RVP% increase is independently associated with adverse LV remodeling and arrhythmic events, serving as a potential clinical risk marker.
Study context
- Population
- Patients with right ventricular pacing (RVP) implantation, May 2013–December 2024, ≥6 months of follow-up and serial RVP% datamedian follow-up 1825 days
- Participants
- 148 patients
- Exposure
- RVP% elevation vs stable RVP%
- Elevationn = 37
- Outcome
- Changes in LVEF and LV end-diastolic dimension
Methodological detailslongitudinal, linear mixed-effects model
- Longitudinal
- Linear mixed-effects model
Main finding
As reported in the abstract
LVEF declined faster, elevation vs stable
−3.33%/y vs −1.81%/y
P = .028
Left ventricular (LV) end-diastolic dimension progressively enlarged, elevation vs stable
+1.19 mm/y vs −0.19 mm/y
P < .001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| VT/VFConfirmed by joint modeling (P = .0002) | 6.48 (3.44–12.2) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
RVP% over time
- RVP% increased significantly over time
- interaction P < .001
Device-detected AF
- No association with AF
- P = 0.33
Heart failure (HF) hospitalization
- HF hospitalization more frequent, elevation vs stable (adjusted HR)
- 3.41; 95% CI 1.42-8.20; P = .006
Original publication
Temporal change in right ventricular pacing ratio and its association with cardiac function and arrhythmia: A linear mixed-effects model analysis. Heart Rhythm. Published 4 December 2025. doi:10.
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