Overview of Electrophysiological and Echocardiographic Findings and Outcomes with His Bundle Pacing for Cardiac Resynchronization

AbstractPurpose of ReviewHis bundle pacing (HBP) is gaining popularity as a therapy for cardiac conduction disease. Utilization of the conduction system with HBP avoids the adverse effects of right ventricular pacing (RVP). Improvements in left ventricular (LV) function, New York Heart Association (NYHA) functional class, and quality of life (QOL) accompanying physiological activation induced by HBP attract attention. This is particularly important given the 30% non-responder rate from cardiac resynchronization therapy (CRT) studies; large number of patients with or at risk for pacing-induced cardiomyopathy and patients with poor coronary sinus (CS) targets.Recent FindingsThe advantages of HBP as an alternative method for resynchronizing failing ventricles are supported by several recent studies, which are detailed in this review. HBP had significant clinical benefits in terms of LV ejection fraction (LVEF), NYHA functional class, and diuretic use. A growing number of case reports from several centers also support this growing trend. Additionally, success rates of in correcting bundle branch block have been reported in a number of studies and appear similar to traditional BiV pacing.SummaryHBP is an attractive alternative to CRT in patients with heart failure and electrical conduction abnormalities. With improvements in guide-catheter design, lead structure, and overall operator experience, increased use and improved outcomes are expected in the next decade.
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research