Electro-energetics of Biventricular, Septal and Conduction System Pacing

Prinzen, Frits W.; Lumens, Joost; Duchenn, J�rgen; Vernooy, Kevin

doi:10.15420/aer.2021.30

Cited by 2 publications

(3 citation statements)

References 54 publications

(70 reference statements)

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“…[ 27 ] It has been reported that the efficiency of cardiac pump function (the amount of stroke work generated by a unit of oxygen consumed) is approximately 30% lower in dyssynchronous than in synchronous hearts. [ 28 ]…”

Section: Pathophysiology Of Pacing-induced Cardiomyopathymentioning

confidence: 99%

“…27 It has been reported that the efficiency of cardiac pump function (the amount of stroke work generated by a unit of oxygen consumed) is approximately 30% lower in dyssynchronous than in synchronous hearts. 28 As a result of non-physiological RV pacing, changes in ventricular blood perfusion, neurohumoral innervation and fatty acid metabolism have also been observed. Moreover, dyssynchrony results in changes in local myocardium oxygen demand.…”

Section: Pathophysiology Of Pacinginduced Cardiomyopathymentioning

confidence: 99%

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Ventricular Dyssynchrony and Pacing-induced Cardiomyopathy in Patients with Pacemakers, the Utility of Ultra-high-frequency ECG and Other Dyssynchrony Assessment Tools

Mizner

Jurák

Línková

et al. 2022

Arrhythm Electrophysiol Rev

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The majority of patients tolerate right ventricular pacing well; however, some patients manifest signs of heart failure after pacemaker implantation and develop pacing-induced cardiomyopathy. This is a consequence of non-physiological ventricular activation bypassing the conduction system. Ventricular dyssynchrony was identified as one of the main factors responsible for pacing-induced cardiomyopathy development. Currently, methods that would allow rapid and reliable ventricular dyssynchrony assessment, ideally during the implant procedure, are lacking. Paced QRS duration is an imperfect marker of dyssynchrony, and methods based on body surface mapping, electrocardiographic imaging or echocardiography are laborious and time-consuming, and can be difficult to use during the implantation procedure. However, the ventricular activation sequence can be readily displayed from the chest leads using an ultra-high-frequency ECG. It can be performed during the implantation procedure to visualise ventricular depolarisation and resultant ventricular dyssynchrony during pacing. This information can assist the electrophysiologist in selecting a pacing location that avoids dyssynchronous ventricular activation.

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Section: Pathophysiology Of Pacing-induced Cardiomyopathymentioning

confidence: 99%

Section: Pathophysiology Of Pacinginduced Cardiomyopathymentioning

confidence: 99%

Ventricular Dyssynchrony and Pacing-induced Cardiomyopathy in Patients with Pacemakers, the Utility of Ultra-high-frequency ECG and Other Dyssynchrony Assessment Tools

Mizner

Jurák

Línková

et al. 2022

Arrhythm Electrophysiol Rev

View full text Add to dashboard Cite

show abstract

“… 16 However, it has been found that the degree of dyssynchrony measured by time-to-peak shortening, strain patterns, or internal stretch fraction in conduction system pacing is moderate and nearly similar to that in physiological conduction and less than that observed in RVP. 17 …”

Section: Introductionmentioning

confidence: 99%

Enhancing cardiac pacing strategies: a review of conduction system pacing compared with right and biventricular pacing and their influence on myocardial function

Mirmaksudov,

Ross,

Kongsgård

et al. 2024

European Heart Journal - Cardiovascular Imaging

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Traditional right ventricular pacing has been linked to the deterioration of both left ventricular diastolic and systolic function. This worsening often culminates in elevated rates of hospitalization due to heart failure, an increased risk of atrial fibrillation, and increased morbidity. While biventricular pacing has demonstrated clinical and echocardiographic improvements in patients afflicted with heart failure and left bundle branch block, it has also encountered significant challenges, such as a notable portion of non-responders and procedural failures attributed to anatomical complexities. In recent time, the interest has shifted towards conduction system pacing, initially His bundle pacing and more recently left bundle branch area pacing, as promising alternatives to the established methods. In contrast to other approaches, conduction system pacing offers the advantage of fostering more physiological and harmonized ventricular activation by directly stimulating the His-Purkinje network. This direct pacing results in a more synchronized systolic and diastolic function of left ventricle compared to right ventricular pacing and biventricular pacing. Of particular note is conduction system pacing’s capacity to yield shorter QRS, conserve left ventricular ejection fraction, and reduced rates of mitral and tricuspid regurgitation when compared to right ventricular pacing. The efficacy of conduction system pacing has also been found to have better clinical and echocardiographic improvement than biventricular pacing in patients requiring cardiac resynchronization. This review will delve into myocardial function in conduction system pacing compared to right ventricular pacing and biventricular pacing.

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Electro-energetics of Biventricular, Septal and Conduction System Pacing

Cited by 2 publications

References 54 publications

Ventricular Dyssynchrony and Pacing-induced Cardiomyopathy in Patients with Pacemakers, the Utility of Ultra-high-frequency ECG and Other Dyssynchrony Assessment Tools

Ventricular Dyssynchrony and Pacing-induced Cardiomyopathy in Patients with Pacemakers, the Utility of Ultra-high-frequency ECG and Other Dyssynchrony Assessment Tools

Enhancing cardiac pacing strategies: a review of conduction system pacing compared with right and biventricular pacing and their influence on myocardial function

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