Related Experiment Video

Updated: Dec 14, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

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

10.8K

Sequential His bundle and left ventricular pacing for cardiac resynchronization

Amrish Deshmukh1, Sudhakar Sattur2, Tim Bechtol3

  • 1Department of Internal Medicine, Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center, University of Michigan, Ann Arbor, Michigan, USA.

Journal of Cardiovascular Electrophysiology
|July 16, 2020
PubMed

Insights

Sequential His bundle and left ventricular pacing offers superior cardiac resynchronization therapy (CRT) by improving electrical synchrony. This novel approach shows promising clinical and echocardiographic improvements in patients with CRT indications.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) aims to improve heart function in patients with heart failure.
  • Biventricular pacing is a standard CRT approach, but fusion with intrinsic conduction can be suboptimal.
  • His bundle pacing (HBP) offers an alternative by preserving intrinsic conduction.

Purpose of the Study:

  • To evaluate the efficacy of sequential His bundle and left ventricular pacing for CRT.
  • To compare electrical synchrony and clinical outcomes with biventricular pacing.

Main Methods:

  • Sequential His bundle and left ventricular pacing was performed in patients with CRT indication when HBP alone was insufficient.
  • QRS duration and area were measured and compared between biventricular pacing and His bundle and left ventricular pacing.
  • Functional status and echocardiographic parameters were assessed during follow-up.

Main Results:

  • His bundle and left ventricular pacing significantly reduced QRS duration (110 ± 14 ms) compared to biventricular pacing (141 ± 15 ms) and baseline (170 ± 21 ms).
  • Paced QRS area was smaller with His bundle and left ventricular pacing (38.5 ± 22.6 µVs) versus biventricular pacing (67.5 ± 24.0 µVs).
  • Left ventricular ejection fraction improved from 27.6% to 41.1%, and functional class improved significantly.

Conclusions:

  • Sequential His bundle and left ventricular pacing achieves superior electrical synchrony compared to biventricular pacing.
  • This pacing strategy shows promising clinical and echocardiographic benefits for CRT patients.
  • His bundle and left ventricular pacing is a viable alternative when HBP alone does not adequately correct QRS duration.
Abstract

Keywords:
His bundle pacingQRS areacardiac resynchronization

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