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His Purkinje Conduction System Pacing: Methods, Mechanisms, and Best Practices

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Cardiac Bioelectric Therapy

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Abstract

Long-term RV apical pacing has been associated with increased risk of atrial fibrillation, heart failure hospitalizations, pacing-induced cardiomyopathy, and associated mortality. The search for an alternative site of pacing for ventricular activation has led us to His–Purkinje conduction system pacing (HP-CSP) which presently includes His bundle pacing (HBP) and left bundle branch pacing (LBBP). HP-CSP results in synchronized ventricular activation by direct stimulation of the His–Purkinje network and may result in prevention of some of the adverse clinical outcomes. HP-CSP can also overcome bundle branch block patterns and might be an option for cardiac resynchronization therapy. In this chapter, we review the anatomy of the conduction system and mechanisms of QRS narrowing with HP-CSP and review some of the best practices during implantation to allow for better long-term performance and outcomes.

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Authors and Affiliations

  1. Division of Cardiology, Rush University Medical Center, Chicago, IL, USA

    Parikshit S. Sharma

  2. Geisinger Commonwealth School of Medicine, Geisinger Heart Institute, Wilkes-Barre, PA, USA

    Pugazhendhi Vijayaraman

Authors
  1. Parikshit S. Sharma
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  2. Pugazhendhi Vijayaraman
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Correspondence to Pugazhendhi Vijayaraman .

Editor information

Editors and Affiliations

  1. Department of Biomedical Engineering, The George Washington University, Washington, DC, USA

    Igor R. Efimov

  2. National Heart & Lung Institute, Imperial College London, London, UK

    Fu Siong Ng

  3. Philips EPD Solutions, Cambridge, MA, USA

    Jacob I. Laughner

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Sharma, P.S., Vijayaraman, P. (2021). His Purkinje Conduction System Pacing: Methods, Mechanisms, and Best Practices. In: Efimov, I.R., Ng, F.S., Laughner, J.I. (eds) Cardiac Bioelectric Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-63355-4_23

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  • DOI: https://doi.org/10.1007/978-3-030-63355-4_23

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-63354-7

  • Online ISBN: 978-3-030-63355-4

  • eBook Packages: MedicineMedicine (R0)

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