Conduction System Pacing for Cardiac Resynchronization Therapy - 15/06/22

Doi : 10.1016/j.ccep.2021.12.005

Bengt Herweg, MD, FHRS ^a,^b,^⁎ , Allan Welter-Frost, MD, MPH ^a,^b, David R. Wilson II, MD ^a,^b, Pugazhendhi Vijayaraman, MD ^c
^a Department of Cardiovascular Sciences, University of South Florida Morsani College of Medicine, South Tampa Center (3rd Floor), Tampa, FL 33606, USA
^b Tampa General Hospital, 1 Tampa General Circle, Tampa, FL 33606, USA
^c Geisinger Heart Institute, Geisinger Commonwealth School of Medicine, 1000 E. Mountain Blvd, Wilkes-Barre, PA 18711, USA

^∗Corresponding author. USF Health, South Tampa Center (3rd Floor),2 Tampa General Circle. Tampa, FL, 33606.USF Health South Tampa Center2 Tampa General CircleTampaFL33606

Résumé

Although conventional biventricular pacing has been shown to benefit patients with heart failure and conduction system disease, there are limitations to its therapeutic success, resulting in widely variable clinical response. Limitations of conventional biventricular pacing evolve around myocardial scar, fibrosis, and inability to effectively stimulate diseased tissue. Several observational and acute hemodynamic studies have demonstrated improved electrical resynchronization and echocardiographic response with conduction system pacing. This article provides a systematic review of conduction system pacing as a physiologic alternative to conventional CRT, which is currently undergoing rigorous investigation.

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Keywords : His bundle pacing, Left bundle area pacing, Physiologic pacing, Cardiac resynchronization therapy, Cardiomyopathy