Cardiac Resynchronization Therapy in Patients With Nonischemic Cardiomyopathy Using Left Bundle Branch Pacing

Huang, Weijian; Wu, Shengjie; Vijayaraman, Pugazhendhi; Su, Lan; Chen, Xueying; Cai, Bingni; Zou, Jiangang; Lan, Rongfang; Fu, Guosheng; Mao, Guangyun; Ellenbogen, Kenneth A.; Whinnett, Zachary I.; Tung, Roderick

doi:10.1016/j.jacep.2020.04.011

Cited by 194 publications

(217 citation statements)

References 33 publications

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“…As compared with HBP, LBBP can correct distal conduction disease and provide excellent lead stability and low capture threshold. Huang et al 28 reported 97% success rate in a prospective multicenter study involving 63 patients with nonischemic cardiomyopathy and LBBB along with normalization of left ventricular ejection fraction (LVEF > 50%) at 1 year. Zhang et al 19 demonstrated resynchronization of ventricular contraction with reverse remodeling and significant improvement in clinical symptoms after LBBP in patients with heart failure, low ejection fraction, and LBBB.…”

Section: Clinical Implications Of Lbbpmentioning

confidence: 99%

Left bundle branch pacing: A comprehensive review

Ponnusamy

Arora

Namboodiri

et al. 2020

Cardiovasc electrophysiol

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135

128

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Cardiac pacing is the only effective therapy for patients with symptomatic bradyarrhythmia. Traditional right ventricular apical pacing causes electrical and mechanical dyssynchrony resulting in left ventricular dysfunction, recurrent heart failure, and atrial arrhythmias. Physiological pacing activates the normal cardiac conduction, thereby providing synchronized contraction of ventricles. Though His bundle pacing (HBP) acts as an ideal physiological pacing modality, it is technically challenging and associated with troubleshooting issues during follow‐up. Left bundle branch pacing (LBBP) has been suggested as an effective alternative to overcome the limitations of HBP as it provides low and stable pacing threshold, lead stability, and correction of distal conduction system disease. This paper will focus on the implantation technique, troubleshooting, clinical implications, and a review of published literature of LBBP.

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Section: Clinical Implications Of Lbbpmentioning

confidence: 99%

Left bundle branch pacing: A comprehensive review

Ponnusamy

Arora

Namboodiri

et al. 2020

Cardiovasc electrophysiol

Self Cite

135

128

View full text Add to dashboard Cite

show abstract

“…CSP can restore the electrical and mechanical dyssynchrony caused by bundle branch block and improve clinical outcomes in patients with heart failure 18–20 . The conduction system abnormalities are thought to be due to focal lesions in the proximal AV conduction system axis in many cases.…”

Section: Implications For Conduction System Pacingmentioning

confidence: 99%

Anatomy of the cardiac conduction system

Padala

Cabrera

Ellenbogen

2020

Pacing Clinical Electrophis

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The specialized cardiomyocytes that constitute the conduction system in the human heart, initiate the electric impulse and result in rhythmic and synchronized contraction of the atria and ventricles. Although the atrioventricular (AV) conduction axis was described more than a century ago by Sunao Tawara, the anatomic pathway for propagation of impulse from atria to the ventricles has been a topic of debate for years. Over the past 2 decades, there has been a resurgence of conduction system pacing (CSP) by implanting pacing leads in the His bundle region in lieu of chronic right ventricular pacing that is associated with worse clinical outcomes. The inherent limitations of implanting the leads in the His bundle region has led to the emergence of left bundle branch area pacing in the past 3 years as an alternative strategy for CSP. The clinical experience from performing CSP has helped electrophysiologists gain deeper insight into the anatomy and physiology of cardiac conduction system. This review details the anatomy of the cardiac conduction system, and highlights some of the recently published articles that aid in better understanding of the AV conduction axis and its variations, the knowledge of which is critical for CSP. The remarkable evolution in technology has led to visualization of the cardiac conduction system using noninvasive, nondestructive high‐resolution contrast‐enhanced micro‐computed tomography imaging that may aid in future CSP. We also discuss from anatomical perspective, the differences seen clinically with His bundle pacing and left bundle branch area pacing.

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“…Zhang and colleagues 3 demonstrated that LBBP can improve LV dyssynchrony in patients with systolic heart failure and LBBB. Huang and colleagues 4 reported 97% success rate in a multicenter prospective study involving 63 patients with nonischemic cardiomyopathy and LBBB. In our patient, LBBB could be successfully corrected by LBBP, with subsequent improvement in functional status and LV ejection fraction.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Resynchronization Therapy in Patients With Nonischemic Cardiomyopathy Using Left Bundle Branch Pacing

Cited by 194 publications

References 33 publications

Left bundle branch pacing: A comprehensive review

Left bundle branch pacing: A comprehensive review

Anatomy of the cardiac conduction system

Aborted ST-elevation myocardial infarction—An unusual complication of left bundle branch pacing

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