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Recent approaches to His-Purkinje system pacing
Li-Ting Cheng1, Jun-Meng Zhang1, Ze-Feng Wang1
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Chinese Medical Journal
|January 8, 2019
Summary
His bundle pacing (HBP) is physiologic but has drawbacks. Left bundle branch pacing (LBBP) is a promising alternative, though its clinical significance requires further study.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Technology
Background:
- Physiologic cardiac pacing has gained prominence.
- His bundle pacing (HBP) is considered highly physiologic but presents challenges.
- Left bundle branch pacing (LBBP) offers a potential alternative for mimicking natural heart activation.
Purpose of the Study:
- To review recent advancements in physiologic cardiac pacing techniques.
- To compare the efficacy and limitations of HBP and LBBP.
Main Methods:
- A comprehensive literature search was conducted on PubMed up to July 2018.
- Keywords included "His bundle branch pacing," "right ventricular pacing," and "physiologic pacing."
- Included fully peer-reviewed English publications without study design restrictions.
Main Results:
- HBP, while physiologic, exhibits disadvantages like high pacing thresholds and procedural difficulties.
- LBBP is theoretically superior to HBP in mimicking native conduction.
- Limited large randomized trials exist for LBBP, leaving its clinical superiority under debate.
Conclusions:
- HBP remains a leading physiologic pacing method despite its limitations.
- Further research is essential to establish the clinical significance and benefits of LBBP.
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