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Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

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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...
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The cardiac conduction system produces and transmits electrical impulses that prompt myocardial contraction, ensuring efficient heart function. This intricate system ensures that the heart beats in a coordinated and efficient manner, beginning with the atria and then the ventricles. The conduction system optimizes cardiac output by maintaining this precise sequence, which is crucial for adequate blood circulation.
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Related Experiment Video

Updated: May 9, 2026

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

Mechanical resynchronization in left bundle branch block achieved by conduction system pacing: A strain-based

Thomas Van Overmeiren1, Pedro G Diogo2, Emine Özpak1

  • 1Department of Cardiology, Ghent University Hospital, Ghent, Belgium.

Heart Rhythm
|May 7, 2026
PubMed
Summary

Left bundle branch area pacing (LBBAP) significantly improves heart mechanics and synchrony. While effective, deep septal pacing showed less resynchronization compared to other LBBAP methods.

Keywords:
Cardiac resynchronizationConduction system pacingHeart failureLeft bundle branch area pacingStrain imaging

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Published on: November 7, 2019

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Pacing

Background:

  • Left bundle branch area pacing (LBBAP) is an alternative to biventricular pacing for cardiac resynchronization therapy (CRT).
  • LBBAP aims to improve synchronous left ventricular (LV) contraction.
  • The mechanical resynchronization achieved with LBBAP requires further characterization.

Purpose of the Study:

  • To evaluate mechanical resynchronization after LBBAP in patients with left bundle branch block (LBBB) or right ventricular pacing (RVP)-induced dyssynchrony.
  • To assess resynchronization across the full spectrum of left ventricular ejection fraction (LVEF).

Main Methods:

  • Multicenter study of patients undergoing LBBAP for LBBB or RVP upgrade.
  • Septal strain imaging used to assess mechanical dyssynchrony and resynchronization at baseline and post-implantation.
  • Analysis of global longitudinal strain (GLS) and mid-septal strain patterns.

Main Results:

  • Left bundle branch pacing (LBBP) confirmed in 71%, LV septal pacing (LVSP) in 14%, and deep septal pacing (DSP) in 15% of patients.
  • Significant immediate and progressive improvement in septal mechanics and GLS post-LBBAP.
  • Resynchronization was comparable between LBBP and LVSP but inferior in DSP, with lower Δ mid-septal PSS and ΔLVEF at one year.

Conclusions:

  • LBBAP effectively achieves substantial mechanical resynchronization with progressive septal mechanical improvement.
  • LBBP and LVSP demonstrated similar resynchronization outcomes.
  • DSP resulted in attenuated resynchronization and was associated with lower LVEF at one year.