Conduction system pacing: promoting the physiology to prevent heart failure

Tun, H. N., Khan, H., Chernikova, D., Mareev, Y., Chakrabarti, S., Thant, M. and Cannata, A. (2023) Conduction system pacing: promoting the physiology to prevent heart failure. Heart Failure Reviews, 28(2), pp. 379-386. (doi: 10.1007/s10741-023-10296-4) (PMID:36781809)

Abstract

Cardiac conduction system pacing provides physiological ventricular activation by directly stimulating the conduction system. This review describes the two types of conduction system pacing: His bundle pacing (HBP) and left bundle area pacing (LBAP). The most significant advantage of HB pacing is that it can provide a regular, narrow QRS; however, the disadvantages are challenging implantation and a high risk of re-intervention due to lead dislodgement and the development of high pacing threshold. LBAP provides optimum physiological activation of the left ventricle by engaging the left bundle/fascicular fibers. LBAP is more physiological than traditional RV apical pacing and could be an attractive alternative to conventional cardiac resynchronization therapy (CRT). The advantages of LBAP are a relatively more straightforward implantation technique than HBP, better lead stability and pacing thresholds. HBP and LBAP are more physiological than right ventricular pacing and may be used instead of conventional pacemakers. Both HBP and LBBP are being investigated as alternatives to conventional CRT.

• Item Type: Articles
• Keywords: His bundle pacing, left bundle area pacing, cardiac resynchronization, heart failure.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mareev, Dr Yury
• Authors: Tun, H. N., Khan, H., Chernikova, D., Mareev, Y., Chakrabarti, S., Thant, M., and Cannata, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Heart Failure Reviews
• Publisher: Springer
• ISSN: 1382-4147
• ISSN (Online): 1573-7322
• Published Online: 14 February 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Heart Failure Reviews 28(2): 379-386
• Publisher Policy: Reproduced under a Creative Commons License