EDITORIAL Base over apex: does site matter for pacing the right ventricle?

This editorial refers to ‘Long-term outcomes in patients with atrioventricular block undergoing septal ventricular lead implantation compared with standard apical pacing’ by A. Kypta et al., † on page 574 Pacing for the relief of bradycardia might be considered a ‘mature ’ therapy, having now been available for 50 years, so it is refreshing to see that there are still many unan-swered questions relating to the practice of pacing the ven-tricle. Although it seems clear from population-based studies that ventricular pacing increases the risk of left ven-tricular dysfunction and that the cumulative percentage of pacing is directly related to that risk,1 it is unclear whether it is simply pacing the ventricle or the site of ven-tricular pacing that is the real problem. Perhaps, the most compelling evidence that right ventricular (RV) apica