What is indicated when V-pacing is above 40%?

When V-pacing exceeds 40%, it suggests an increased reliance on ventricular pacing due to inadequate intrinsic conduction. This situation can indicate that the patient is potentially benefiting from advanced pacing strategies like Cardiac Resynchronization Therapy (CRT) or His bundle pacing.

CRT is particularly beneficial for patients with heart failure and left bundle branch block, as it improves the synchronization of the heart's contractions, which can enhance cardiac output and patient outcomes. His bundle pacing allows for more physiological pacing by activating the heart's conduction system in a manner that more closely mimics natural heart function, potentially resulting in improved heart function and reduced pacing dependence.

In contrast, low V-pacing rates might suggest good intrinsic conduction, while higher rates indicate a potential need to optimize pacing strategies. Thus, when V-pacing is above 40%, it aligns with the need for more advanced interventions to improve cardiac function and reduce the negative implications of excessive ventricular pacing.