Assessment of Ventricular Pacing in the Setting of an Institutional Improvement Program: Insights into Physiological Pacing

BACKGROUND Excessive ventricular pacing is known to be detrimental. The purpose of this study was to assess ventricular pacing in the setting of an institutional improvement program in order to decrease unnecessary pacing. METHOD This cross-sectional single-center study performed in a university hospital assessed 80 consecutive patients attending for a cardiac electronic device (pacemaker or cardioverter defibrillator) check. Forty percent of ventricular pacing was set as the cutoff level beyond which pacing was considered excessive. RESULTS Three patients were excluded. Forty-six (59.7%) patients (group 1) had more than 40% ventricular pacing and 31 (40.3%) patients (group 2) showed ventricular pacing less than 41%. In group 1, corrective action was successful in 27 (58.7%) patients, but 19 (41.3%) continued to have ventricular pacing over 40% and were discussed accordingly. An improvement program was established at the institution in order to decrease unnecessary ventricular pacing. CONCLUSION Unnecessary ventricular pacing was encountered in many of the patients in this study, corrective actions were performed, and an institutional improvement project was set up as a consequence.