Permanent His Bundle Pacing for Cardiac Resynchronization

Huang, William A.; Wassie, Maereg; Ajijola, Olujimi A.

doi:10.1007/s11936-018-0616-0

Cited by 4 publications

(4 citation statements)

References 54 publications

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“…13 Various studies have demonstrated that HBP can deliver better electrical synchrony compared to BiV-CRT, resulting in improvement of LVEF, life quality and NYHA functional class. [14][15][16][17] However, HBP is technically challenging due to its anatomical location and high capture threshold.. 18 In the largest prospective study with HBP-CRT conducted by Huang et al,…”

Section: Discussionmentioning

confidence: 99%

“…Conduction system pacing has emerged as a feasible pacing strategy for CRT in heart failure patients with LBBB 13 . Various studies have demonstrated that HBP can deliver better electrical synchrony compared to BiV‐CRT, resulting in improvement of LVEF, life quality and NYHA functional class 14‐17 . However, HBP is technically challenging due to its anatomical location and high capture threshold.…”

Section: Discussionmentioning

confidence: 99%

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Remarkable response to cardiac resynchronization therapy via left bundle branch pacing in patients with true left bundle branch block

Guo

Xiao

et al. 2020

Clinical Cardiology

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Background: Left bundle branch pacing (LBBP) has been suggested as an alternative means to deliver cardiac resynchronization therapy (CRT). Hypothesis: LBBP may deliver resynchronization therapy along with an advantage over traditional biventricular (BiV) pacing in clinical outcomes. Methods: Heart failure patients who presented LBBB morphology according to Strauss's criteria and received successful CRT procedure were enrolled in the present study. Propensity score matching was applied to match patients into LBBP-CRT group and BiV-CRT group. Then, the electrographic data, the echocardiographic data and New York heart association (NYHA) class were compared between the groups. Results: Twenty-one patients with successful LBBP procedure and another 21 matched patients with successful BiV-CRT procedure were finally enrolled in the study. The QRS duration (QRSd) was narrowed from 167.7 ± 14.9 ms to 111.7 ± 12.3 ms (P < .0001) in the LBBP-CRT group and from 163.6 ± 13.8 ms to 130.1 ± 14.0 ms (P < .0001) in the BiV-CRT group. A trend toward better left ventricular ejection fraction (LVEF) was recorded in the LBBP-CRT group (50.9 ± 10.7% vs 44.4 ± 13.3%, P = .12) compared to that in the BiV-CRT group at the 6-month follow-up. A trend toward better echocardiographic response was documented in patients receiving LBBP-CRT procedure (90.5% vs 80.9%, P = .43) and more super CRT response was documented in the LBBP-CRT group (80.9% vs 57.1%, P = .09) compared to that in the BiV-CRT group. Conclusions: LBBP-CRT can dramatically improve the electrical synchrony in heart failure patients with LBBB. Meanwhile, compared with the traditional BiV-CRT, it has Jincun Guo and Linlin Li contributed equally to this work.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Remarkable response to cardiac resynchronization therapy via left bundle branch pacing in patients with true left bundle branch block

Guo

Xiao

et al. 2020

Clinical Cardiology

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“…Additionally, the capture thresholds have been shown to be stable over long-term allaying the concerns about quicker battery depletion due to higher followup thresholds [31,32]. Similarly, procedure and luoroscopy times have improved over time, consistent with the learning curve of adopting a new technique and can be comparable with implantation of traditional right ventricular pacing leads [19,33,34].…”

Section: Procedural Characteristics Of Hbp Compared With Biventriculamentioning

confidence: 83%

His bundle pacing in heart failure: A review of current literature

Chaudhary¹,

Garg²

2020

J Cardiol Cardiovasc Med

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Biventricular (BiV) pacing revolutionized the heart failure management in patients with sinus rhythm and left bundle branch block; however, left ventricular-lead placement is not always technically possible. Also, BiV pacing does not fully normalize ventricular activation and, therefore, the ventricular resynchronization is imperfect. On the other hand, right ventricular pacing for bradycardia may cause or worsen heart failure in some patients by causing dyssynchronous ventricular activation. His bundle pacing comes as an alternative to current approaches as it activates the ventricles via the native His-Purkinje system, resulting in true physiological pacing, and, therefore, is a promising site for pacing in bradycardia and traditional CRT indications in cases where it can overcome left bundle branch block. Furthermore, it has the potential to open up new indications for pacing therapy in heart failure, such as targeting patients with PR prolongation, but a narrow QRS duration. In this article we explore the history, clinical evidence, proposed mechanisms, procedural characteristics, and the role in current therapy of His bundle pacing in the prevention and treatment of heart failure.

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“…With increased operator experience and improved lead delivery systems, HBP success rates and safety have improved and are comparable to traditional RV pacing. Battery longevity is also likely comparable to traditional BiV CRT devices and therefore, we can anticipate the use of HBP CRT to grow significantly in future [ 74 ]. The HOPE-HF trial, a multicentre, double-blind, randomized, crossover study, is currently in the process of recruiting patients.…”

Section: Minimizing the Deleterious Effects Of Rv Apical Pacingmentioning

confidence: 99%

Adverse Consequences of Right Ventricular Apical Pacing and Novel Strategies to Optimize Left Ventricular Systolic and Diastolic Function

Khurwolah

Yao

Kong

2019

CCR

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Several studies have focused on the deleterious consequences of Right Ventricular Apical (RVA) pacing on Left Ventricular (LV) function, mediated by pacing-induced ventricular dyssynchrony. Therapeutic strategies to reduce the detrimental consequences of RVA pacing have been proposed, that includes upgrading of RVA pacing to Cardiac Resynchronization Therapy (CRT), alternative Right Ventricular (RV) pacing sites, minimal ventricular pacing strategies, as well as atrial-based pacing. In developing countries, single chamber RV pacing still constitutes a majority of cases of permanent pacing, and assessment of the optimal RV pacing site is of paramount importance. In chronically-paced patients, it is crucial to maintain as close and normal LV physiological function as possible, by minimizing ventricular dyssynchrony, reducing the chances for heart failure and other complications to develop. This review provides an analysis of the deleterious immediate and long-term consequences of RVA pacing, and the most recent available evidence regarding improvements in pacing options and strategies to optimize LV diastolic and systolic function. Furthermore, the place of advanced echocardiography in the identification of patients with pacing-induced LV dysfunction, the potential role of a new predictor of LV dysfunction in RV-paced subjects, and the long- term outcomes of patients with RV septal pacing will be explored.

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Permanent His Bundle Pacing for Cardiac Resynchronization

Cited by 4 publications

References 54 publications

Remarkable response to cardiac resynchronization therapy via left bundle branch pacing in patients with true left bundle branch block

Remarkable response to cardiac resynchronization therapy via left bundle branch pacing in patients with true left bundle branch block

His bundle pacing in heart failure: A review of current literature

Adverse Consequences of Right Ventricular Apical Pacing and Novel Strategies to Optimize Left Ventricular Systolic and Diastolic Function

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