A beginner's guide to permanent left bundle branch pacing.
About: This article is published in Heart Rhythm.The article was published on 2019-06-22 and is currently open access. It has received 370 citations till now.
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TL;DR: LBBP is a feasible and effective method for achieving electric resynchronization of LBBB, with resultant improvements in left ventricular structure and function, and low and stable pacing thresholds may be advantageous over His bundle pacing for CRT in patients with L BBB and nonischemic cardiomyopathy.
168 citations
TL;DR: The concept of pacing the conduction system distal to the His bundle to bypass the region of conduction block was proposed and the procedural feasibility of left bundle branch pacing was demonstrated.
165 citations
TL;DR: Left bundle branch pacing appears to be a promising method for delivering CRT with similar improvements in symptoms and LV function with LBBP and HBP, significantly greater than those seen in patients treated with BVP, in this non-randomized study.
158 citations
References
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TL;DR: The case shows a novel pacing strategy for patients with BBB that affects many patients with heart failure, and demonstrates the feasibility of pacing the left bundle branch (LBB) immediately beyond the conduction block to functionally restore the impaired His-Purkinje conduction system.
450 citations
TL;DR: HBP and LBBAP may significantly increase the overall success of physiologic pacing and be feasible in a high percentage of patients with low thresholds during acute follow-up.
245 citations
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The Commonwealth Medical College1, Cleveland Clinic2, Indiana University3, University of Chicago4, Rush University Medical Center5, Vanderbilt University6, Duke University7, University of California, San Francisco8, American University of Beirut9, Rutgers University10, Albert Einstein College of Medicine11, University of Missouri12
TL;DR: The anatomy of the His bundle, early clinical observations, and current approaches to permanent HBP are reviewed, showing promise as an attractive mode to achieve physiological pacing.
208 citations
TL;DR: In this paper, the authors performed detailed intracardiac mapping of left septal conduction to LBBB patterns in patients with left bundle-branch block (LBBB) patterns.
Abstract: Background: Septal activation in patients with left bundle-branch block (LBBB) patterns has not been described previously. We performed detailed intracardiac mapping of left septal conduction to as...
199 citations
TL;DR: P pHBP improved LVEF, LVESV and NYHA Class in patients with HF with typical LBBB, and remained stable with acute threshold of 2.5 ms at 3-year follow-up (p>0.05).
Abstract: Objectives His bundle pacing (HBP) can potentially correct left bundle branch block (LBBB). We aimed to assess the efficacy of HBP to correct LBBB and long-term clinical outcomes with HBP in patients with heart failure (HF). Methods This is an observational study of patients with HF with typical LBBB who were indicated for pacing therapy and were consecutively enrolled from one centre. Permanent HBP leads were implanted if the LBBB correction threshold was Results In 74 enrolled patients (69.6±9.2 years and 43 men), LBBB correction was acutely achieved in 72 (97.3%) patients, and 56 (75.7%) patients received permanent HBP (pHBP) while 18 patients did not receive permanent HBP (non-permanent HBP), due to no LBBB correction (n=2), high LBBB correction thresholds (n=10) and fixation failure (n=6). The median follow-up period of pHBP was 37.1 (range 15.0–48.7) months. Thirty patients with pHBP had completed 3-year follow-up, with LVEF increased from baseline 32.4±8.9% to 55.9±10.7% (p 0.05). Conclusions pHBP improved LVEF, LVESV and NYHA Class in patients with HF with typical LBBB.
182 citations