Impact of physiologic pacing versus right ventricular pacing among patients with left ventricular ejection fraction greater than 35%: A systematic review for the 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay

Abstract

Impact of physiologic pacing versus right ventricular pacing among patients with left ventricular ejection fraction greater than 35%: a systematic review for the 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm 2019;16:e280-e298. This article has been copublished in the Journal of the American College of Cardiology and Circulation. Copies: This document is available on the websites of the American College of Cardiology (www.acc.org), American Heart Association (professional.heart.org), and the Heart Rhythm Society (www.hrsonline.org).

A novel ECG‐based algorithm to determine right ventricular lead placement in permanent pacemaker patients (RVpace study)

“…Finally, an anterior RVOT position was incorporated into the algorithm to differentiate between the actual proximal septum and RVOT. Due to the presumed superiority of the proximal septum/para‐Hisian region for the localization of RV lead our algorithm focused on this position …”

“…Due to the presumed superiority of the proximal septum/ para-Hisian region for the localization of RV lead our algorithm focused on this position. [3][4][5][6][7]15,16 To verify the clinical utility of our ECG algorithm, we decided to test it in 31 consecutive patients treated for many years with permanent RV pacing who had been scheduled for the elective replacement of their PMs in our Department. In those patients, the localization of the RV PL was independently analyzed by two methods: by our ECG algorithm and by ECHO and investigators performing those analyses, who were blinded to each other.…”

“…Other pacing sites, such as interventricular septum (IVS) or the right ventricular outflow tract (RVOT), might be superior to the apical pacing due to a better hemodynamic profile and a lower risk of both acute and subacute complications of the implantation, including cardiac perforations . The His‐bundle pacing has been considered superior to the other sites of RV pacing due to numerous surrogate endpoints, but so far the clear clinical benefit seems to be limited to a certain group of patients with atrial fibrillation and atrioventricular node ablation and more studies are warranted . What is more, His‐bundle pacing requires special training and equipment, therefore, might not be the first choice option in many centers.…”

“…[3][4][5] The His-bundle pacing has been considered superior to the other sites of RV pacing due to numerous surrogate endpoints, but so far the clear clinical benefit seems to be limited to a certain group of patients with atrial fibrillation and atrioventricular node ablation and more studies are warranted. 6,7 What is more, His-bundle pacing requires special training and equipment, therefore, might not be the first choice option in many centers.…”

Permanent His bundle pacing in heart failure patients: A systematic review and meta‐analysis

“…Some even suggested HBP as the first‐line therapy for heart failure and LV dyssynchrony . Recent guidelines have given HBP a class IIa recommendation in lieu of right ventricular pacing in patients with reduced LV ejection fraction (LVEF) (between 36% and 50%), who require chronic ventricular pacing . We systematically reviewed currently available literature and carried out this meta‐analysis to estimate the efficacy of HBP in heart failure patients.…”