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Related Experiment Video

Updated: Jun 9, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Left ventricular endocardial stimulation for severe heart failure.

Pierre Bordachar¹, Nicolas Derval, Sylvain Ploux

¹Bordeaux University 2 and University Medical Center of Bordeaux, Bordeaux, France. bordacharp@hotmail.com

Journal of the American College of Cardiology

|August 28, 2010

Summary

Endocardial stimulation for biventricular resynchronization offers superior hemodynamic performance over epicardial methods. Further research is needed to develop safe instrumentation and confirm its superiority for cardiac resynchronization therapy.

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Published on: January 31, 2019

Area of Science:

Cardiology
Medical Devices
Electrophysiology

Background:

Biventricular resynchronization therapy (CRT) is crucial for patients with left ventricular (LV) dysfunction and ventricular dyssynchrony.
Standard CRT involves implanting an LV lead via the coronary sinus, which can be technically challenging and occasionally unsuccessful.
Transseptal LV lead implantation is an alternative but carries risks; however, recent studies suggest superior hemodynamic performance with endocardial stimulation.

Purpose of the Study:

To review the advantages and disadvantages of LV endocardial stimulation.
To examine current and future techniques for LV endocardial stimulation.
To discuss the potential of endocardial stimulation in CRT.

Main Methods:

Review of existing literature on LV lead implantation techniques.
Analysis of recent studies in animal models and humans comparing endocardial and epicardial stimulation.
Discussion of technical challenges, risks, and potential benefits of transvenous and transseptal LV lead placement.

Main Results:

Endocardial stimulation demonstrated distinctly superior hemodynamic performance compared to epicardial stimulation in recent studies.
Transseptal LV lead implantation, while technically difficult, offers an alternative when standard methods fail.
LV endocardial stimulation shows promise for improving CRT outcomes.

Conclusions:

LV endocardial stimulation presents a promising alternative for CRT, offering superior hemodynamic benefits.
Successful implementation requires advancements in safe, durable instrumentation and reliable methods for optimal site identification.
Controlled trials are necessary to validate the superiority of endocardial stimulation over standard CRT.