Related Experiment Video

Updated: Dec 1, 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

His bundle pacing: Clinical consequences of unnecessary right ventricle backup pacing

Leonardo Marinaccio1, Daniele Giacopelli2, Domenico Marchese1

  • 1Department of Cardiology, Presidio Ospedaliero di Piove di Sacco, Piove di Sacco (PD), Italy.

Journal of Electrocardiology
|November 10, 2020
PubMed

Insights

In His-bundle pacing (HBP), connecting the backup right ventricle (RV) lead to the left ventricular (LV) port in CRT devices can cause unnecessary RV pacing. Switching to LV-only pacing improved cardiac function in a case report.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Medical Device Technology

Background:

  • His-bundle pacing (HBP) is an advanced pacing technique aiming for physiological ventricular activation.
  • In His-bundle pacing implants, a backup lead in the right ventricle (RV) is often connected to the left ventricular (LV) port of a cardiac resynchronization therapy (CRT) device for patients in sinus rhythm.
  • Current CRT device programming can lead to continuous RV backup pacing due to cross-channel ventricular refractory periods.

Observation:

  • Unnecessary RV pacing, even when the His-bundle lead is functioning, can occur.
  • This continuous RV pacing may capture myocardial tissue, potentially counteracting the benefits of His-bundle pacing.
  • A case report highlighted this phenomenon in a patient receiving His-bundle pacing.

Findings:

  • Switching from biventricular pacing to LV-only pacing in this patient led to immediate improvements.
  • Echocardiography parameters demonstrated enhanced cardiac function at both acute and 2-month follow-ups after the pacing strategy adjustment.
  • This suggests that avoiding unnecessary RV pacing is crucial for optimizing His-bundle pacing outcomes.

Implications:

  • Optimizing CRT device programming for His-bundle pacing is essential to maximize patient benefits.
  • Avoiding unnecessary RV pacing can preserve battery life and prevent potential negative effects on myocardial function.
  • This case underscores the importance of individualized pacing strategies and device management in cardiac electrophysiology.

Keywords:
Backup pacingHis bundle pacingProgramingTroubleshooting

More Related Videos

Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding10:39

Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding

Published on: August 30, 2024

1.1K
Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device07:41

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device

Published on: July 20, 2022

2.2K

Related Concept Videos

Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
193
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
2.0K
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
188
Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
443
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
338
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
236