Keeping pace with the competition: His bundle versus biventricular pacing in heart failure

Purpose of review His bundle pacing (HBP) has emerged as a novel method to achieve electrical resynchronization in bundle branch block and as an alternative means to deliver cardiac resynchronization therapy (CRT). There are now data on HBP in CRT-eligible patients from cohort studies and a single pilot randomized controlled trial (RCT). Recent findings Early clinical data regarding HBP in heart failure have demonstrated echocardiographic and functional improvement similar to traditional biventricular pacing (BiV), mostly when utilized as a bailout to traditional BiV-CRT. A single pilot RCT, His-SYNC, showed a trend toward greater echocardiographic response in an on-treatment analysis, but was underpowered. No large RCTs have reported long-term clinical outcomes. In order to realize any benefit from HBP, output-dependent morphology changes must be demonstrated to ensure the conduction system capture is present. There may be a role for corrective HBP in patients with right bundle branch block and after atrioventricular node ablation, which is theoretically more desirable than traditional BiV. Importantly, however, HBP is likely not to benefit patients with nonspecific intraventricular conduction delay. Summary HBP is emerging as an alternative strategy for CRT and may have a role in patients in whom traditional BiV is not achievable or ineffective.
Source: Current Opinion in Cardiology - Category: Cardiology Tags: CARDIAC FAILURE: Edited by Rebecca Cogswell and Gene Kim Source Type: research

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Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
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Source: Current Heart Failure Reports - Category: Cardiology Source Type: research
Authors: Poulin A, Beaupré F, Gravel C, Hadjadj S, Bernier M, Beaudoin J, O'Connor K, Ferreira-Neto AN, Wintzer J, Dumont E, Dagenais F, Rodés-Cabau J, Paradis JM Abstract BACKGROUND: Many patients referred for a MitraClip intervention are finally refused for this intervention, and data are very scarce on their outcomes. Our study sought to determine the characteristics and outcomes of patients who are referred to a mitral valve clinic and are finally denied from a percutaneous mitral edge-to-edge repair. METHODS: A total of 210 patients referred to our clinic for severe mitral regurgitation were ...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
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Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
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Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
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Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
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Source: Current Cardiology Reports - Category: Cardiology Source Type: research
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Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Clinical Science (Poster Session) Source Type: research
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Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ‐ DEVICES Source Type: research
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