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Updated: Aug 25, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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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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The Effects of His Bundle Pacing Compared to Classic Resynchronization Therapy in Patients with Pacing-Induced

Rafal Gardas1,2, Krzysztof S Golba1,2, Tomasz Soral1

  • 1Department of Electrocardiology, Leszek Giec Upper-Silesian Medical Centre, Silesian Medical University, 40-055 Katowice, Poland.

Journal of Clinical Medicine
|October 14, 2022
PubMed

Insights

His bundle pacing (HBP) offers a superior alternative to biventricular pacing (BVP) for patients with pacing-induced cardiomyopathy (PICM) undergoing cardiac resynchronization therapy (CRT) upgrades. HBP demonstrated greater improvements in QRS duration, clinical outcomes, and left ventricular function.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Medicine

Background:

  • Pacing-induced cardiomyopathy (PICM) is a common complication of right ventricular pacing.
  • Cardiac resynchronization therapy (CRT) is the recommended treatment for PICM.
  • His bundle pacing (HBP) offers a potential alternative to biventricular pacing (BVP) by restoring synchronous ventricular activation.

Purpose of the Study:

  • To evaluate the efficacy of His bundle pacing (HBP) compared to biventricular pacing (BVP) in patients with pacing-induced cardiomyopathy (PICM) undergoing cardiac resynchronization therapy (CRT) upgrade.
  • To assess improvements in electrocardiographic, clinical, and echocardiographic parameters following HBP versus BVP.

Main Methods:

  • A prospective cohort study included patients with PICM scheduled for CRT upgrade.
  • Patients received either His bundle pacing (HBP) or biventricular pacing (BVP).
  • Measurements of QRS duration, New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF), and left ventricle reverse remodeling were recorded at baseline and six-month follow-up.

Main Results:

  • His bundle pacing (HBP) was successful in 83% of patients.
  • HBP resulted in a significantly greater reduction in QRS duration compared to BVP (118.3 ms vs. 150.5 ms).
  • Improvements in NYHA class, LVEF, and left ventricle reverse remodeling were more pronounced with HBP than with BVP.

Conclusions:

  • His bundle pacing (HBP) is a viable and effective alternative to biventricular pacing (BVP) for cardiac resynchronization therapy (CRT) upgrades in patients with pacing-induced cardiomyopathy (PICM).
  • HBP facilitates more significant improvements in ventricular synchrony, clinical status, and cardiac structure compared to BVP.

Keywords:
His bundle pacingcardiac resynchronization therapyconduction system pacingpacing-induced cardiomyopathy

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