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Clinical outcomes of His-Purkinje conduction system pacing

Amal Muthumala1, Pugazhendhi Vijayaraman2

  • 1North Middlesex University Hospital and St Bartholomew's Hospital, London, UK.

Pacing and Clinical Electrophysiology : PACE
|August 28, 2020
PubMed

Insights

His-Purkinje conduction system pacing (HPCSP), including His bundle pacing (HBP) and left bundle branch pacing (LBBP), offers normal heart activation, preventing negative effects of traditional pacing. This review examines HPCSP

Area of Science:

  • Cardiology and Electrophysiology
  • Cardiac Pacing and Conduction System

Background:

  • Traditional right ventricular pacing can lead to adverse ventricular remodeling and dysfunction.
  • His-Purkinje conduction system pacing (HPCSP) aims to restore physiological ventricular activation.
  • His bundle pacing (HBP) is established, while left bundle branch pacing (LBBP) is an emerging technique.

Purpose of the Study:

  • To review the clinical outcomes of His-Purkinje conduction system pacing (HPCSP).
  • To evaluate the impact of HPCSP on mortality, heart failure hospitalizations, and symptoms.
  • To compare the efficacy of HBP and LBBP within the HPCSP strategy.

Main Methods:

  • Systematic review of existing literature on His-Purkinje conduction system pacing (HBP and LBBP).
  • Analysis of clinical outcomes including mortality, morbidity (heart failure hospitalization), and symptom scores.
  • Inclusion of studies reporting on implantation techniques and pacing parameters.

Main Results:

  • HPCSP facilitates normal left ventricular activation, mitigating risks associated with RV pacing.
  • Established data exists for HBP, with international implantation guidelines available.
  • LBBP shows promise with potential advantages in pacing parameters and clinical outcomes.

Conclusions:

  • HPCSP represents a significant advancement in pacing, promoting physiological ventricular activation.
  • Clinical outcomes data supports HPCSP for various indications, including CRT and bradycardia.
  • Further research into LBBP is warranted to fully elucidate its benefits and long-term impact.

Keywords:
His bundle pacingcardiac resynchronization therapyclinical outcomesleft bundle branch pacing

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