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Enhancing cardiac pacing strategies: a review of conduction system pacing compared with right and biventricular pacing and their influence on myocardial function.

Authors :
Mirmaksudov, Mirakhmadjon
Ross, Stian
Kongsgård, Erik
Edvardsen, Thor
Source :
European Heart Journal - Cardiovascular Imaging; Jul2024, Vol. 25 Issue 7, p879-887, 9p
Publication Year :
2024

Abstract

Traditional right ventricular pacing (RVP) has been linked to the deterioration of both left ventricular diastolic and systolic function. This worsening often culminates in elevated rates of hospitalization due to heart failure, an increased risk of atrial fibrillation, and increased morbidity. While biventricular pacing (BVP) has demonstrated clinical and echocardiographic improvements in patients afflicted with heart failure and left bundle branch block, it has also encountered significant challenges such as a notable portion of non-responders and procedural failures attributed to anatomical complexities. In recent times, the interest has shifted towards conduction system pacing, initially, His bundle pacing, and more recently, left bundle branch area pacing, which are seen as promising alternatives to established methods. In contrast to other approaches, conduction system pacing offers the advantage of fostering more physiological and harmonized ventricular activation by directly stimulating the His–Purkinje network. This direct pacing results in a more synchronized systolic and diastolic function of the left ventricle compared with RVP and BVP. Of particular note is the capacity of conduction system pacing to yield a shorter QRS, conserve left ventricular ejection fraction, and reduce rates of mitral and tricuspid regurgitation when compared with RVP. The efficacy of conduction system pacing has also been found to have better clinical and echocardiographic improvement than BVP in patients requiring cardiac resynchronization. This review will delve into myocardial function in conduction system pacing compared with that in RVP and BVP. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20472404
Volume :
25
Issue :
7
Database :
Complementary Index
Journal :
European Heart Journal - Cardiovascular Imaging
Publication Type :
Academic Journal
Accession number :
178338092
Full Text :
https://doi.org/10.1093/ehjci/jeae090