Is There Any Advantage For Dual Chamber AV Sequential Pacing?

Is there any advantage for dual chamber AV sequential pacing?

In dual chamber AV sequential pacing, right atrium is paced initially and the right ventricle paced after a delay. This facilitates ventricular filling by atrial contraction. This is more important in those with stiff ventricles. Normally atrial contraction contributes to only about 15% of ventricular filling. But in a ventricle with difficulty in relaxing, atrial contribution may be as high as 30%.

Dual chamber pacemaker is naturally more expensive and the battery life is lesser. Pacing the right ventricle has a disadvantage of producing left ventricular dyssynchrony and a potentially higher risk of heart failure in the long run. Hence now there is a trend to pace in the region of the left bundle branch to avoid this, though it is technically more challenging.