Study of impact of dual chamber pacing on right atrial function.

At the outset, we will obtain necessary approvals, including IRC (Institutional Review Committee), IEC (Institutional Ethics Committee) approval, and registration with CTRI (Clinical Trials Registry - India). Our study will focus on patients aged 18 years and above, who undergo dual chamber pacemaker implantation. Before the study, we will approach these patients and provide a detailed explanation of the research. Upon their understanding and agreement, informed consent will be obtained. Demographic details and clinical data and treatment receiving will be collected using proforma. Echocardiography will be done as a standard care in which RA size, RA area, RV wall thickness, RVOT diameter, TAPSE, IVC diameter and E/A ratio will be measured. Speckle-tracking echo will be done to measure RA strain, Strain rate and RV strain. Echocardiography will be done at 3 different dates. First echo will be done 1-2 days prior to pacemaker implantation. Second echo will be done 1-2 days after the pacemaker implantation and the third echo will be done after 1 month of procedure during follow-up. Patients with RV pacing of more than 40% will be included in this study. There will be no need for additional visits or follow-up in this study.