Related Experiment Video

Updated: Oct 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

10.6K

His Bundle pacing for congenital complete AV block: An attempt to fix a broken heart?

Giuseppe Pio Piemontese1, Matteo Ziacchi1, Giovanni Statuto1

  • 1Department of Experimental, Diagnostic and Specialty Medicine, Institute of Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|March 2, 2022
PubMed

Insights

Congenital complete atrioventricular block (CCAVB) often requires pacemakers. His bundle pacing (HBP) in CCAVB patients improved exercise tolerance and cardiac function by restoring normal heart activation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pediatric Cardiology

Background:

  • Congenital complete atrioventricular block (CCAVB) necessitates pacemaker implantation for most affected individuals.
  • Chronic right ventricular (RV) pacing in CCAVB can lead to adverse cardiac remodeling and dysfunction.
  • Restoring atrioventricular (AV) and interventricular synchrony is crucial for optimal outcomes.

Observation:

  • Two patients with CCAVB underwent cardiac resynchronization therapy using His bundle pacing (HBP).
  • HBP utilizes the His-Purkinje system to mimic physiological conduction.
  • This approach aims to prevent dyssynchrony associated with conventional pacing.

Findings:

  • Patients demonstrated improved exercise tolerance post-HBP.
  • Echocardiographic assessments revealed improvements in left ventricular function.
  • These improvements suggest a reversal of pacing-induced left ventricular dysfunction.

Implications:

  • His bundle pacing (HBP) offers a potential alternative to conventional RV pacing in CCAVB.
  • Restoring physiological activation via the His-Purkinje network may mitigate long-term cardiac complications.
  • HBP could be a valuable strategy for cardiac resynchronization in congenital heart disease.

Keywords:
congenital atrioventricular blockhis bundle pacingleft ventricular dysfunctionventricular dyssynchrony

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