Honing in on optimal ventricular pacing sites: an argument for his bundle pacing

Current Treatment Options in Cardiovascular Medicine
Mark Young LeeDaniel Lawrence Lustgarten

Abstract

Frequent ventricular pacing is often or completely unavoidable in patients with high-grade or complete heart block. Over time, patients with high-burden RV pacing are at risk for developing symptomatic cardiomyopathy due to pacing-induced ventricular dyssynchrony. Growing awareness of this concern has generated interest in alternative pacing sites like the septum and outflow tract, the thinking being that these sites will more closely mimic His-Purkinje-mediated ventricular activation. Numerous studies have met with mixed results likely due to the fact that-to quote Marvin Gaye-there ain't nothing like the real thing. Herein lies the advantage of His bundle pacing (HBP), as it is the only pacing modality capable of physiological ventricular activation. HBP has been demonstrated to be safe and reliable in various forms of AV block with minimal drawbacks, namely modestly higher pacing thresholds when compared with other RV sites. Additionally, HBP is a truly physiologic alternative to biventricular pacing to effect cardiac resynchronization therapy (CRT), a concept supported by small observational and prospective studies. In our view, His bundle pacing should be considered in nearly all patients requiring ventricular pacing.

References

Jan 1, 1976·Cardiovascular Research·D O WilliamsP Samet
Jul 1, 1971·Circulation·T N James, L Sherf
Mar 1, 1967·Journal of Applied Physiology·B J ScherlagA N Damato
Mar 1, 1984·The American Journal of Cardiology·H O HirzelH P Krayenbuehl
Mar 15, 1997·Journal of the American College of Cardiology·H F Tse, C P Lau
Oct 20, 1999·Pacing and Clinical Electrophysiology : PACE·P P KarpawichJ E Haas
Jan 12, 2001·Journal of the American College of Cardiology·E I SkalidisP E Vardas
Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
Oct 24, 2002·Journal of the American College of Cardiology·Hung Fat TseChu Pak Lau
Jan 3, 2003·JAMA : the Journal of the American Medical Association·Bruce L WilkoffUNKNOWN Dual Chamber and VVI Implantable Defibrillator Trial Investigators
Jul 5, 2003·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·C C de CockJ W Twisk
Dec 18, 2003·Journal of Cardiovascular Electrophysiology·Bruce S StamblerUNKNOWN ROVA Investigators
Jun 11, 2004·Pacing and Clinical Electrophysiology : PACE·Pramod M Deshmukh, Mary Romanyshyn
Nov 3, 2004·Journal of the American College of Cardiology·Maher NahlawiJeffrey J Goldberger
Dec 24, 2004·European Heart Journal·Kevin VernooyFrits W Prinzen
Apr 15, 2005·Journal of Cardiovascular Electrophysiology·Jonathan S SteinbergUNKNOWN MADIT II Investigators
May 5, 2005·Pacing and Clinical Electrophysiology : PACE·S Serge Barold, I Eli Ovsyshcher
Jul 13, 2005·Pacing and Clinical Electrophysiology : PACE·Pablo Moriña-VázquezManuel Herrera-Carranza
Jul 15, 2005·The New England Journal of Medicine·William D ToffUNKNOWN United Kingdom Pacing and Cardiovascular Events Trial Investigators
Jul 30, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Arjun D SharmaUNKNOWN DAVID Investigators
Jan 18, 2006·Journal of the American College of Cardiology·Michael O Sweeney, Frits W Prinzen
Nov 23, 2006·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Domenico CatanzaritiGiuseppe Vergara
Jan 5, 2007·Pacing and Clinical Electrophysiology : PACE·F CantùA Gavazzi
Sep 7, 2007·The New England Journal of Medicine·Michael O SweeneyUNKNOWN Search AV Extension and Managed Ventricular Pacing for Promoting Atrioventricular Conduction (SAVE PACe) Trial
Oct 2, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Wen-Hao LiuHsueh-Wen Chang
Apr 12, 2008·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Alexander KyptaRobert Hofmann
Apr 15, 2008·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Francesco ZanonFrits W Prinzen
Sep 27, 2008·Revista española de cardiología·Rafael Barba-PichardoManuel Herrera-Carranza
Mar 11, 2009·Pacing and Clinical Electrophysiology : PACE·Panayota FlevariDimitrios Th Kremastinos

❮ Previous
Next ❯

Citations

Jun 18, 2016·Current Cardiology Reports·Mads Brix Kronborg, Jens Cosedis Nielsen
Aug 4, 2016·Journal of Electrocardiology·Alexandra E TengOlujimi A Ajijola
Jan 8, 2019·Chinese Medical Journal·Li-Ting ChengYong-Quan Wu
Apr 14, 2020·International Journal of Sports Physiology and Performance·Katie E McGibbonDavid B Pyne

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Related Papers

Journal of the American College of Cardiology
Miriam ShanksJeroen J Bax
Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Abdul GhaniArif Elvan
Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Paul W X FoleyFrancisco Leyva
© 2021 Meta ULC. All rights reserved