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Left Ventricular Endocardial Pacing: Update and State of the Art
Pierre Bordachar1, Marc Strik1, Sylvain Ploux1
1Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Avenue Magellan, 33600 Pessac, France; IHU Liryc, Electrophysiology and Heart Modeling Institute, Avenue Haut Lévêque, 33600 Pessac, France.
Abstract:
Initially, left ventricular (LV) endocardial pacing was performed as a bailout procedure after unsuccessful transvenous cardiac resynchronization therapy implantation in the presence of surgical contraindications. Additional possible advantages of endocardial LV pacing are a more physiologic activation, being less arrhythmogenic, more effective on the hemodynamic level, with better thresholds, and without the risk of phrenic stimulation. Different techniques have been proposed to stimulate the LV endocardium in humans, with feasibility and safety studies involving limited numbers of patients. In this review, we will describe the different techniques proposed to allow LV endocardial pacing, the results observed, and then we will discuss the reasons why LV endocardial pacing seems to be out of fashion today and what are the possible perspectives for development.
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