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His Bundle Pacing Versus Biventricular Pacing for CRT

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Clinical Controversies in Device Therapy for Cardiac Arrhythmias

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Abstract

Cardiac resynchronization therapy (CRT) by the way of biventricular (BiV) pacing is an established component of heart failure treatment in selected patients and aims at reestablishing synchrony between right ventricular and left ventricular activation [1]. However, this form of cardiac excitation fails to emulate the multisite simultaneous endo- to epicardial activation resulting in torsional contraction, which is critical to achieve optimal cardiac output.

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Notes

  1. 1.

    CRT is indicated in systolic heart failure NYHA class II–IV, with LVEF ≤35% and LBBB with QRS ≥150 ms (class I recommendation – 2012 focused update of 2008 guidelines).

  2. 2.

    Selective His bundle capture is only identical to intrinsic conduction if bundle branch disease is absent at baseline. Underlying bundle branch block can normalize with His bundle pacing.

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Authors and Affiliations

  1. University of Vermont Medical Center, Burlington, VT, USA

    Nicole Habel & Daniel L. Lustgarten

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  1. Nicole Habel
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  2. Daniel L. Lustgarten
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Correspondence to Daniel L. Lustgarten .

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Editors and Affiliations

  1. University of Rochester School of Medicine & Dentistry/Hackensack Meridian, School of Medicine at Seton Hall, University/Summit Medical Group, Short Hills, NJ, USA

    Jonathan S. Steinberg

  2. Electrophysiology Section, Cardiovascular Division, Univeristy of Pennsylvania, and the Cardiology Division, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA

    Andrew E. Epstein

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Habel, N., Lustgarten, D.L. (2019). His Bundle Pacing Versus Biventricular Pacing for CRT. In: Steinberg, J., Epstein, A. (eds) Clinical Controversies in Device Therapy for Cardiac Arrhythmias . Springer, Cham. https://doi.org/10.1007/978-3-030-22882-8_7

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  • DOI: https://doi.org/10.1007/978-3-030-22882-8_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-22881-1

  • Online ISBN: 978-3-030-22882-8

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