What long-term adverse effect may result from right ventricular pacing?

• A. Improved left ventricular function
• B. Decreased risk of arrhythmias
• C. Improved overall cardiac output
• D. Development of left ventricular dysfunction or heart failure

Answer: (D)

The development of left ventricular dysfunction or heart failure is a well-documented long-term adverse effect that can result from right ventricular pacing. This occurs because right ventricular pacing can lead to asynchronous contraction of the ventricles. When the pacing leads to the right ventricle contracting without appropriate timing with the left ventricle, it disrupts the coordinated contraction that is essential for optimal heart function.

Over time, this asynchrony can cause a decline in the function of the left ventricle, ultimately leading to dilatation and a decrease in contractility. This deterioration in left ventricular function can progress to heart failure in susceptible patients. Thus, monitoring the impact of right ventricular pacing on overall cardiac function is critical to mitigating these long-term risks.