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Updated: Sep 7, 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

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Left Bundle Branch Pacing: How I Do It?

Lan Su1, Kenneth A Ellenbogen2, Weijian Huang1

  • 1Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China.

Cardiac Electrophysiology Clinics
|June 17, 2022
PubMed

Insights

Combining His-bundle pacing (HBP) with His-Optimized CRT (HOT-CRT) or left bundle branch area pacing (LBBAP) with LB-Optimized CRT (LOT-CRT) shows promise for cardiac resynchronization therapy.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
  • Conventional CRT involves biventricular pacing (BVP).
  • Limitations exist in BVP response rates and optimal lead placement.

Purpose of the Study:

  • To review the literature on combined His-bundle pacing (HBP) and left ventricular (LV) lead use.
  • To explore the emerging concepts of His-Optimized CRT (HOT-CRT) and LB-Optimized CRT (LOT-CRT).

Main Methods:

  • Literature search for studies combining LV lead with HBP.
  • Literature search for studies combining LV lead with left bundle branch area pacing (LBBAP).
  • Review of case studies and mechanistic studies.

Main Results:

  • Two clinical outcome case studies and one mechanistic study found for HBP + LV lead.
  • One case series reported outcomes in patients with inadequate response to HBP who received an additional LV lead.
  • Two case series studies found for LBBAP + LV lead in non-peer-reviewed publications.

Conclusions:

  • His-Optimized CRT (HOT-CRT) describes combining HBP with LV pacing.
  • LB-Optimized CRT (LOT-CRT) describes combining LBBAP with LV pacing.
  • These novel pacing strategies warrant further investigation for CRT optimization.

Keywords:
Cardiac resynchronization therapyConduction system captureHis bundle branch pacing (HBP)Implantation technologyLeft bundle branch pacing (LBBP)

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