His Bundle Pacing LBBB Reversal Biventricular Pacing LV LV LV RV RV RV Mean LV Activation Time Reduction SBP change compared to intrinsic activation Above: Epicardial maps of LV and RV activation in one patient during intrinsic rhythm (LBBB), His pacing (LBBB has resolved) and biventricular pacing. The colour scale (left) shows that the late (blue) activation of the LV in intrinsic activation is not seen with His pacing: LBBB is overcome, shortening LV Activation Time (LVAT). BVP shows earliest (red) activation apically, as expected, in both the RV and LV. Right: Left Ventricular Activation Time is reduced by His Bundle Pacing (HBP) overcoming LBBB. Biventricular Pacing (BVP) also reduces activation time but to a lesser extent. BP is improved by BVP, but not as much as with HBP with resolution of LBBB. The white
BVP HBPLVAT reduction from intrinsic (ms)
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