Left Ventricular Endocardial Pacing : Update and State of the Art - 15/06/22

Doi : 10.1016/j.ccep.2021.12.004

Pierre Bordachar, MD, PhD ^a,^b, Marc Strik, MD, PhD ^a,^b,^⁎ , Sylvain Ploux, MD, PhD ^a,^b
^a Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Avenue Magellan, 33600 Pessac, France
^b IHU Liryc, Electrophysiology and Heart Modeling Institute, Avenue Haut Lévêque, 33600 Pessac, France

^∗Corresponding author. Service Pr Haïssaguerre, Hôpital cardiologique du Haut-Lévêque, Avenue de Magellan, Pessac 33600, France.Service Pr HaïssaguerreHôpital cardiologique du Haut-LévêqueAvenue de MagellanPessac33600France

Résumé

Initially, left ventricular (LV) endocardial pacing was performed as a bailout procedure after unsuccessful transvenous cardiac resynchronization therapy implantation in the presence of surgical contraindications. Additional possible advantages of endocardial LV pacing are a more physiologic activation, being less arrhythmogenic, more effective on the hemodynamic level, with better thresholds, and without the risk of phrenic stimulation. Different techniques have been proposed to stimulate the LV endocardium in humans, with feasibility and safety studies involving limited numbers of patients. In this review, we will describe the different techniques proposed to allow LV endocardial pacing, the results observed, and then we will discuss the reasons why LV endocardial pacing seems to be out of fashion today and what are the possible perspectives for development.

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Keywords : Encocardium, Endocardial, CRT, Left ventricle, Pacing

Plan

Funding: This work received financial support from the French Government as part of the “Investments of the Future” program managed by the National Research Agency (ANR) [Grant number ANR-10-IAHU-04].