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Background The aim of the study was to compare the effects of right ventricular apical (RVA) pacing or right ventricular outflow tract (RVOT) pacing on P wave dispersion and ventricular synchronism and left ventricular function.Methods (1) 51 patients who had atriventricular block (AV block) or sick sinus syndrome (SSS) were implanted DDD or VVI pacemaker.RVA pacing was conducted in 26 patients (13 males and 13 females) with a mean age of (66.8±7.5) years,and RVOT pacing was conducted in 25 patients (13 males and 12 females) with a mean age of (67.4±7.3) years.