Related Experiment Video

Updated: Feb 4, 2026

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

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His-Bundle Pacing and LV Endocardial Pacing as Alternatives to Traditional Cardiac Resynchronization Therapy

Pugazhendhi Vijayaraman1, Faiz A Subzposh2

  • 1Division of Cardiac Electrophysiology, Geisinger Heart Institute, MC 36-10, 1000 E Mountain Blvd, Wilkes-Barre, PA, 18711, USA. pvijayaraman1@geisinger.edu.

Current Cardiology Reports
|September 28, 2018
PubMed

Insights

His-bundle pacing and left ventricular endocardial pacing offer promising alternatives for cardiac resynchronization therapy (CRT) in patients unresponsive to biventricular pacing, improving heart function and outcomes.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) with biventricular pacing (BVP) is standard for heart failure with left bundle branch block.
  • A significant portion of patients (up to one-third) do not respond adequately to BVP.

Purpose of the Study:

  • To review the effectiveness of His-bundle pacing (HBP) and left ventricular (LV) endocardial pacing as alternatives to BVP.
  • To assess their potential for achieving ventricular synchrony in non-responsive patients.

Main Methods:

  • Review of observational studies and emerging clinical data on HBP and LV endocardial pacing.
  • Analysis of pacing techniques, lead placement, and physiological activation patterns.

Main Results:

  • HBP has demonstrated significant QRS narrowing/normalization and improved clinical outcomes, including ejection fraction.
  • LV endocardial pacing shows promise, offering improved site selection and more physiological LV activation compared to epicardial pacing.
  • Both HBP and LV endocardial pacing have shown positive results as rescue or primary CRT options.

Conclusions:

  • His-bundle pacing and LV endocardial pacing represent valuable alternatives to conventional BVP for CRT.
  • Ongoing randomized clinical trials are crucial for a comprehensive understanding of their long-term benefits and optimal application.
Abstract

Keywords:
Biventricular pacingCardiac resynchronization therapyHis-bundle pacingLV endocardial pacing

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