scholarly journals His Bundle Pacing: State of the Art

2018 ◽  
Vol 12 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Matthew F Yuyun ◽  
Ghulam Muqtada Chaudhry
Keyword(s):  
Right Ventricular ◽  
Biventricular Pacing ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Future Perspective ◽  
Functional Mitral Regurgitation ◽  
Ventricular Pacing ◽  
Right Ventricular Pacing ◽  
His Bundle ◽  
His Bundle Pacing

Traditional right ventricular pacing can be associated with adverse remodeling, leading to left ventricular dysfunction, functional mitral regurgitation, left atrial dilatation, as well as atrial and ventricular arrhythmias. His bundle pacing (HBP) has emerged as a viable and reliable alternative to right ventricular pacing. HBP has been around since the 1970s, but remained dormant even after the index clinical study in humans in 2000. However, with recently rejuvenated interest, it appears to be a promising strategy for achieving synchronous ventricular pacing. Multiple studies have now shown that HBP is feasible, safe, and offers better outcomes when compared with right ventricular pacing. It has also emerged as an alternative to biventricular pacing for the provision of cardiac resynchronization therapy. This review gives a systematic appraisal of the history, feasibility, safety, techniques, efficacy, benefits, complications, and challenges, and offers a future perspective, of HBP.

scholarly journals Left bundle branch pacing: the new kid on the block

2021 ◽  
Vol 30 (4) ◽  
pp. 571-575
Author(s):  
Andra Gurgu ◽  
Dragos Cozma ◽  
Mihail G. Chelu
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Current Status ◽  
Ventricular Pacing ◽  
Right Ventricular Pacing ◽  
His Bundle ◽  
His Bundle Pacing ◽  
Physiologic Form ◽  
Increased Risk

Right ventricular pacing is has deletorius effects due to left ventricular dysynchrony and remodelling and may result in heart failure. Over the last decade, His bundle pacing has emerged as the most physiologic form pacing. However, it has limitations, such as higher capture thresholds, lower R wave amplitudes, atrial oversensing, and increased risk for lead revisions from late threshold increase with subsequent premature battery depletion, which has prevented a wider adoption of this technique in routine clinical practice. Left bundle branch pacing has been developed as an alternative physiologic pacing strategy that overcomes most of His bundle pacing limitations. This article summarizes the current status of left bundle branch pacing. Keywords: His bundle pacing, left bundle branch pacing, cardiac resynchronization, therapy heart failure.

scholarly journals A network meta-analysis and systematic review of change in QRS duration after left bundle branch pacing, His bundle pacing, biventricular pacing, or right ventricular pacing in patients requiring permanent pacemaker

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nithi Tokavanich ◽  
Narut Prasitlumkum ◽  
Wimwipa Mongkonsritragoon ◽  
Wisit Cheungpasitporn ◽  
Charat Thongprayoon ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Biventricular Pacing ◽  
Meta Analysis ◽  
Mean Difference ◽  
Ventricular Pacing ◽  
Right Ventricular Pacing ◽  
His Bundle ◽  
His Bundle Pacing ◽  
Significant Difference ◽  
Qrs Duration

AbstractCardiac dyssynchrony is the proposed mechanism for pacemaker-induced cardiomyopathy, which can be prevented by biventricular pacing. Left bundle branch pacing and His bundle pacing are novel interventions that imitate the natural conduction of the heart with, theoretically, less interventricular dyssynchrony. One of the surrogate markers of interventricular synchrony is QRS duration. Our study aimed to compare the change of QRS duration before and after implantation between types of cardiac implantable electronic devices (CIEDs): left bundle branch pacing versus His bundle pacing versus biventricular pacing and conventional right ventricular pacing. A literature search for studies that reported an interval change of QRS duration after CIED implantation was conducted utilizing the MEDLINE, EMBASE, and Cochrane databases. All relevant works from database inception through November 2020 were included in this analysis. A random-effects model, Bayesian network meta-analysis was used to analyze QRS duration changes (eg, electrical cardiac synchronization) across different CIED implantations. The mean study sample size, from 14 included studies, was 185 subjects. The search found 707 articles. After exclusions, 14 articles remained with 2,054 patients. The His bundle pacing intervention resulted in the most dramatic decline in QRS duration (mean difference, − 53 ms; 95% CI − 67, − 39), followed by left bundle branch pacing (mean difference, − 46 ms; 95% CI − 60, − 33), and biventricular pacing (mean difference, − 19 ms; 95% CI − 37, − 1.8), when compared to conventional right ventricle apical pacing. When compared between LBBP and HBP, showed no statistically significant wider QRS duration in LBBP with mean different 6.5 ms. (95% CI − 6.7, 21). Our network meta-analysis found that physiologic pacing has the greatest effect on QRS duration after implantation. Thus, HBP and LBBP showed no significant difference between QRS duration after implantation. Physiologic pacing interventions result in improved electrocardiography markers of cardiac synchrony, narrower QRS duration, and might lower electromechanical dyssynchrony.

Acute Effects of His Bundle Pacing Versus Left Ventricular and Right Ventricular Pacing on Left Ventricular Function

2007 ◽  
Vol 100 (10) ◽  
pp. 1556-1560 ◽  
Author(s):  
Luigi Padeletti ◽  
Randy Lieberman ◽  
Jan Schreuder ◽  
Antonio Michelucci ◽  
Andrea Collella ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Ventricular Pacing ◽  
Acute Effects ◽  
Right Ventricular Pacing ◽  
His Bundle ◽  
His Bundle Pacing

scholarly journals Alternative sites of ventricular pacing: His bundle pacing

2020 ◽  
Vol 90 (2) ◽  
Author(s):  
Francesco Vetta ◽  
Leonardo Marinaccio ◽  
Giampaolo Vetta
Keyword(s):  
Heart Failure ◽  
Biventricular Pacing ◽  
Scientific Evidence ◽  
Cardiac Pacing ◽  
Cardiac Conduction ◽  
Cardiac Resynchronization ◽  
Conduction Delay ◽  
Ventricular Pacing ◽  
His Bundle ◽  
His Bundle Pacing

Since its introduction right ventricular apical (RVA) pacing has been the mainstay in cardiac pacing. However, in recent years there has been an upsurge of interest in permanent His bundle pacing (HBP), given the scientific evidence of the harmful role of dyssynchronous ventricular activation, induced by RVA pacing, in promoting the onset of heart failure and atrial fibrillation. After an intermediate period in which attention was focused on algorithms aimed at minimizing ventricular pacing, with partially inadequate and harmful results, scientific attention shifted to HBP, which proved to ensure a physiological electro-mechanical activation of the ventricles. The encouraging results obtained have allowed the introduction of HBP in recent guidelines for cardiac pacing in patients with bradicardia and cardiac conduction delay. Recent studies have also demonstrated the potential of HBP in patients with left bundle branch block and heart failure. HBP is promising as an attractive way to achieve physiological stimulation in patients with an indication for cardiac resynchronization therapy (CRT). Comparative studies of HB-CRT and biventricular pacing have shown similar results in numerically modest cohorts, although HB-CRT has been shown to promote better ventricular electrical resynchronization as demonstrated by a greater QRS narrowing. A widespread use of this pacing tecnique also depends on improvements in technology, as well as further validation of effectiveness in large randomised clinical trials

scholarly journals His bundle pacing after failure of cardiac resynchronization therapy: a case study

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092349
Author(s):  
Katarína Koščová ◽  
Milan Chovanec ◽  
Jan Petrů ◽  
Lucie Šedivá ◽  
Libor Dujka ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Cardiac Pacing ◽  
Cardiac Resynchronization ◽  
Ventricular Pacing ◽  
Resynchronization Therapy ◽  
Bundle Branch Block ◽  
Right Ventricular Pacing ◽  
His Bundle ◽  
His Bundle Pacing

His bundle pacing is a relatively new method of cardiac pacing. This method is used in patients with atrioventricular block to prevent heart failure associated with right ventricular pacing, and in patients with bundle branch block and cardiomyopathy. We report a patient with cardiomyopathy and left bundle branch block with failure of cardiac resynchronization therapy. Permanent His bundle pacing was associated with clinical improvement and improvement of parameters of cardiac function.

Permanent His-bundle pacing is feasible, safe, and superior to right ventricular pacing in routine clinical practice

Heart Rhythm ◽  
2015 ◽  
Vol 12 (2) ◽  
pp. 305-312 ◽  
Author(s):  
Parikshit S. Sharma ◽  
Gopi Dandamudi ◽  
Angela Naperkowski ◽  
Jess W. Oren ◽  
Randle H. Storm ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Right Ventricular ◽  
Routine Clinical Practice ◽  
Ventricular Pacing ◽  
Right Ventricular Pacing ◽  
His Bundle ◽  
His Bundle Pacing
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