scholarly journals Control of Refractory Recurrent Ventricular Tachyarrhythmias by Artificial Cardiac Pacing A Preliminary Report on the use of His Bundle Electrogram in Determining the Indication

1974 ◽  
Vol 38 (2) ◽  
pp. 87-95 ◽  
Author(s):  
CHUICHI KAWAI
Keyword(s):  
Preliminary Report ◽  
Cardiac Pacing ◽  
Ventricular Tachyarrhythmias ◽  
His Bundle ◽  
Determining The Indication

Physiological Pacing: A New Road to Future

2021 ◽  
pp. 263246362097804
Author(s):  
Vanita Arora ◽  
Pawan Suri
Keyword(s):  
Side Effects ◽  
Fibrous Tissue ◽  
Cardiac Pacing ◽  
His Bundle ◽  
Anatomy And Physiology ◽  
Long Term Follow Up ◽  
Pacing Lead ◽  
The Right

Anatomy and physiology are the basis of human body functioning and as we have progressed in management of various diseases, we have understood that physiological intervention is always better than an anatomical one. For more than 50 years, a standard approach to permanent cardiac pacing has been an anatomical placement of transvenous pacing lead at the right ventricular apex with a proven benefit of restoring the rhythm. However, the resultant ventricular dyssynchrony on the long-term follow-up in patients requiring more than 40% ventricular pacing led to untoward side effects in the form of heart failure and arrhythmias. To counter such adverse side effects, a need for physiological cardiac pacing wherein the electrical impulse be transmitted directly through the normal conduction system was sought. His bundle pacing (HBP) with an intriguing alternative of left bundle branch pacing (LBBP) is aimed at restoring such physiological activation of ventricles. HBP is safe, efficacious, and feasible; however, localization and placement of a pacing lead at the His bundle is challenging with existing transvenous systems due to its small anatomic size, surrounding fibrous tissue, long-learning curve, and the concern remains about lead dislodgement and progressive electrical block distal to the HBP lead. In this article, we aim to take the reader through the challenging journey of HBP with focus upon the hardware and technique, selective versus nonselective HBP, indications and potential disadvantages, and finally the future prospects.

scholarly journals Technological advances in cardiac pacing and defibrillation

2019 ◽  
Vol 3 (Issue 3) ◽  
pp. 95
Author(s):  
Sok-Sithikun Bun ◽  
Fabien Squara ◽  
Didier Scarlatti ◽  
Guillaume Theodore ◽  
Decebal Gabriel Latcu ◽  
...  
Keyword(s):  
Femoral Vein ◽  
Cardiac Pacing ◽  
Half Century ◽  
His Bundle ◽  
His Bundle Pacing ◽  
Subcutaneous Defibrillator ◽  
Technological Advances ◽  
Recent Developments

Since more than a half century, cardiac pacing and defibrillation represent a field in constant evolution, and they have shown some great technological advances from its conception to its methods of insertion. In this review, the recent developments about the accesses for pacemakers and ICD will be described: the axillary and the femoral vein. The His bundle pacing and the advantages of the entirely subcutaneous defibrillator will also be presented.

scholarly journals Alternative sites of ventricular pacing: His bundle pacing

2020 ◽  
Vol 90 (2) ◽  
Author(s):  
Francesco Vetta ◽  
Leonardo Marinaccio ◽  
Giampaolo Vetta
Keyword(s):  
Heart Failure ◽  
Biventricular Pacing ◽  
Scientific Evidence ◽  
Cardiac Pacing ◽  
Cardiac Conduction ◽  
Cardiac Resynchronization ◽  
Conduction Delay ◽  
Ventricular Pacing ◽  
His Bundle ◽  
His Bundle Pacing

Since its introduction right ventricular apical (RVA) pacing has been the mainstay in cardiac pacing. However, in recent years there has been an upsurge of interest in permanent His bundle pacing (HBP), given the scientific evidence of the harmful role of dyssynchronous ventricular activation, induced by RVA pacing, in promoting the onset of heart failure and atrial fibrillation. After an intermediate period in which attention was focused on algorithms aimed at minimizing ventricular pacing, with partially inadequate and harmful results, scientific attention shifted to HBP, which proved to ensure a physiological electro-mechanical activation of the ventricles. The encouraging results obtained have allowed the introduction of HBP in recent guidelines for cardiac pacing in patients with bradicardia and cardiac conduction delay. Recent studies have also demonstrated the potential of HBP in patients with left bundle branch block and heart failure. HBP is promising as an attractive way to achieve physiological stimulation in patients with an indication for cardiac resynchronization therapy (CRT). Comparative studies of HB-CRT and biventricular pacing have shown similar results in numerically modest cohorts, although HB-CRT has been shown to promote better ventricular electrical resynchronization as demonstrated by a greater QRS narrowing. A widespread use of this pacing tecnique also depends on improvements in technology, as well as further validation of effectiveness in large randomised clinical trials

scholarly journals His bundle pacing after failure of cardiac resynchronization therapy: a case study

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052092349
Author(s):  
Katarína Koščová ◽  
Milan Chovanec ◽  
Jan Petrů ◽  
Lucie Šedivá ◽  
Libor Dujka ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Cardiac Pacing ◽  
Cardiac Resynchronization ◽  
Ventricular Pacing ◽  
Resynchronization Therapy ◽  
Bundle Branch Block ◽  
Right Ventricular Pacing ◽  
His Bundle ◽  
His Bundle Pacing

His bundle pacing is a relatively new method of cardiac pacing. This method is used in patients with atrioventricular block to prevent heart failure associated with right ventricular pacing, and in patients with bundle branch block and cardiomyopathy. We report a patient with cardiomyopathy and left bundle branch block with failure of cardiac resynchronization therapy. Permanent His bundle pacing was associated with clinical improvement and improvement of parameters of cardiac function.

scholarly journals Direct His Bundle and Parahisian Cardiac Pacing

2012 ◽  
Vol 17 (2) ◽  
pp. 70-78 ◽  
Author(s):  
Francesco Zanon ◽  
S. S. Barold
Keyword(s):  
Cardiac Pacing ◽  
His Bundle

scholarly journals Learning Curve for Left Bundle Branch Area Pacing – the Experience of a Romanian Academic Center

2021 ◽  
Vol 31 (2) ◽  
pp. 327-334
Author(s):  
Catalin PESTREA ◽  
Alexandra GHERGHINA ◽  
Irina PINTILIE ◽  
Florin ORTAN
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Learning Curve ◽  
Cardiac Pacing ◽  
Cardiac Resynchronization ◽  
Qrs Complex ◽  
Resynchronization Therapy ◽  
Pacing Threshold ◽  
Bundle Branch Block ◽  
His Bundle ◽  
His Bundle Pacing

Introduction: There is an increasing interest in the past decade for more physiological pacing strategies due to detrimental long-term right ventricular pacing. His bundle pacing is the most physiological one, but it has some drawbacks, mainly an increased pacing threshold. Left bundle branch area pacing (LBBAP) emerged in the recent years as the next step in conduction system pacing. We present our initial experience and learning curve with this latter procedure. Material and methods: During January 2019 and February 2021, 20 patients with pacing indications that failed initial permanent His bundle pacing underwent successful LBBAP. Results: The mean age was 65.9 ± 12.7 years. The indications for cardiac pacing were AV block in 14 patients(70%) and cardiac resynchronization therapy in 6 patients (30%). At baseline, normal QRS complex was noted in 9 patients, a left bundle branch block pattern in 10 patients and a right bundle branch block in one patient. A total of 18 dual-chamber and one single chamber pacemakers were implanted and a cardiac resynchronization therapy defibrillator (CRT-D) device. The acute pacing threshold was 0.56±0.2 V at 0.4ms, the sensing threshold was 10.3±3.9 mV and the impedance was 684.9±112.2 Ω. The overall QRS duration decreased after LBBAP from 128.5 ± 27ms to 103.6 ± 17.4ms (p= 0.001). In patients with baseline wide QRS complex there was a highly significant decrease from 148.2 ± 11.6 ms to 104.7 ± 19.4 ms (p<0.001). The fl uoroscopy time, including the time spent for His bundle location, was 13.8 ± 8.5 minutes. The pacing thresholds remained constant after three-months (0.6 ± 0.2 V vs. 0.56 ± 0.2 V at 0.4 ms). We had two intraprocedural septal perforations without any consequences and three micro dislodgements at follow-up with pure left septal capture. Conclusion: Left bundle branch area pacing is a feasible physiological pacing technique with a high success rate and the potential to overcome the limits of permanent His bundle pacing. It can be successfully performed virtually in all types of pacing indications, including cardiac resynchronization therapy as provides a rapid and synchronous activation of the left ventricle.

His bundle recordings in atypical A-V nodal wenckebach block during cardiac pacing

1971 ◽  
Vol 27 (5) ◽  
pp. 570-576 ◽  
Author(s):  
Cesar Castillo ◽  
Orlando Maytin ◽  
Agustin Castellanos
Keyword(s):  
Cardiac Pacing ◽  
His Bundle ◽  
Wenckebach Block

scholarly journals How to Implant His Bundle and Left Bundle Pacing Leads: Tips and Pearls

2021 ◽  
Vol 7 ◽  
Author(s):  
Shunmuga Sundaram Ponnusamy ◽  
Pugazhendhi Vijayaraman
Keyword(s):  
Cardiac Pacing ◽  
Cardiac Resynchronisation Therapy ◽  
His Bundle ◽  
His Bundle Pacing ◽  
Increased Risk ◽  
Cardiac Resynchronisation ◽  
Significant Efficacy ◽  
Resynchronisation Therapy ◽  
Right Ventricular Apical Pacing ◽  
Tools And Techniques

Cardiac pacing is the treatment of choice for the management of patients with bradycardia. Although right ventricular apical pacing is the standard therapy, it is associated with an increased risk of pacing-induced cardiomyopathy and heart failure. Physiological pacing using His bundle pacing and left bundle branch pacing has recently evolved as the preferred alternative pacing option. Both His bundle pacing and left bundle branch pacing have also demonstrated significant efficacy in correcting left bundle branch block and achieving cardiac resynchronisation therapy. In this article, we review the implantation tools and techniques to perform conduction system pacing.

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