Rick Schreurs

55 Cardiac pacing in first degree AV-block CONCLUSIONS The combination of computational, experimental and clinical studies provides strong confirmation of previous evidence that normalizing AV-coupling by biventricular pacing in hearts with prolonged PR-interval improves cardiac pump function. This improvement is predominantly achieved by better ventricular filling, caused by a combined effect of reduction in diastolic MR and increase in diastolic forward flow. Pacing-induced ventricular dyssynchrony, caused by RV pacing, attenuates the benefit of restored AV-coupling. Therefore, this study may pave the way for a novel pacing-based therapeutic approach in patients with heart failure and prolonged PR-interval that is not part of current guidelines. 3