Advertisement
Canadian Journal of Cardiology

A Novel Pacing Strategy With Low and Stable Output: Pacing the Left Bundle Branch Immediately Beyond the Conduction Block

Published:September 21, 2017DOI:https://doi.org/10.1016/j.cjca.2017.09.013

      Abstract

      This report demonstrates the feasibility of pacing the left bundle branch (LBB) immediately beyond the conduction block to functionally restore the impaired His-Purkinje conduction system in a patient with heart failure and left bundle branch block (LBBB). The pacing required only a low pacing output (0.5 volts/0.5 ms) to correct the LBBB with accompanying right BBB on the electrocardiogram. Over 1-year of follow-up, the patient had a significant improvement in clinical outcome and echocardiographic measurements. The case shows a novel pacing strategy for patients with BBB that affects many patients with heart failure.

      Résumé

      Le présent rapport démontre la faisabilité de la stimulation de la branche gauche (BG) immédiatement après le bloc de conduction pour restaurer de manière fonctionnelle le système de conduction de His et Purkinje chez un patient qui présente une insuffisance cardiaque et un bloc de branche gauche (BBG). La stimulation a seulement exigé une faible sortie de stimulation (0,5 volts/0,5 ms) pour corriger le BBG associé au BB droit à l’électrocardiogramme. Au cours du suivi de 1 an, le patient a connu une nette amélioration des résultats cliniques et des mesures échocardiographiques. Ce cas montre une nouvelle stratégie de stimulation chez les patients présentant un BB (qui touche un grand nombre de patients atteints d’insuffisance cardiaque).
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Canadian Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Su L.
        • Xu L.
        • Wu S.J.
        • Huang W.J.
        Pacing and sensing optimization of permanent His-bundle pacing in cardiac resynchronization therapy/implantable cardioverter defibrillators patients: value of integrated bipolar configuration.
        Europace. 2016; 18: 1399-1405
        • Ajijola O.A.
        • Upadhyay G.
        • Macias C.
        • et al.
        Permanent His bundle pacing for cardiac resychronization therapy: initial feasibility study in lieu of left ventricular lead.
        Heart Rhythm. 2017; 14: 1353-1361
        • Lustgarten D.L.
        • Crespo E.M.
        • Arkhipova-Jenkins I.
        • et al.
        His-bundle pacing versus biventricular pacing in cardiac resynchronization therapy patients: a crossover design comparison.
        Heart Rhythm. 2015; 12: 1548-1557
        • Huang W.J.
        • Su L.
        • Wu S.J.
        • et al.
        Benefits of permanent His Bundle pacing combined with atrioventricular node ablation in atrial fibrillation patients with heart failure with both preserved and reduced left ventricular ejection fraction.
        J Am Heart Assoc. 2017; 6: e005309