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How His bundle pacing prevents and reverses heart failure induced by right ventricular pacing

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Abstract

Ideal heart performance demands vigorous systolic contractions and rapid diastolic relaxation. These sequential events are precisely timed and interdependent and require the rapid synchronous electrical stimulation provided by the His-Purkinje system. Right ventricular (RV) pacing creates slow asynchronous electrical stimulation that disrupts the timing of the cardiac cycle and results in left ventricular (LV) mechanical asynchrony. Long-term mechanical asynchrony produces LV dysfunction, remodeling, and clinical heart failure. His bundle pacing preserves synchronous electrical and mechanical LV function, prevents or reverses RV pacemaker-induced remodeling, and reduces heart failure.

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Authors and Affiliations

  1. Cardiovascular Associates of the Southeast, Birmingham, AL, USA

    Alfred Stanley Jr

  2. Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA

    Constantine Athanasuleas

  3. Division of Cardiac Surgery, Department of Surgery, Cardiovascular Center at UCLA, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Gerald Buckberg

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Stanley, A., Athanasuleas, C. & Buckberg, G. How His bundle pacing prevents and reverses heart failure induced by right ventricular pacing. Heart Fail Rev 26, 1311–1324 (2021). https://doi.org/10.1007/s10741-020-09962-8

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