Biventricular pacing (BVP) was initially developed as an electrical therapy for patients
having advanced heart failure with reduced ejection fraction (EF), left bundle branch
block (LBBB), and delayed activation of the lateral left ventricular (LV) wall. Cardiac
resynchronization therapy (CRT) using BVP significantly improves LV function, clinical
outcomes, and survival in this group of patients. The response rate and the magnitude
of response to BVP can vary significantly.
1
Ploux et al
- Epstein A.E.
- DiMarco J.P.
- Ellenbogen K.A.
- et al.
2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS2008 guidelines
for device-based therapy of cardiac rhythm abnormalities: a report of the American
College of Cardiology Foundation/American Heart Association Task Force on Practice
Guidelines and the Heart Rhythm Society.
Heart Rhythm. 2012; 9: 1524-1576
2
have shown that BVP does not eliminate electrical dyssynchrony induced by LBBB but
results in moderate reduction in LV activation times, which are still significantly
longer than those observed during normal QRS. This finding suggests that there is
significant potential for improvement in CRT.To read this article in full you will need to make a payment
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References
- 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society.Heart Rhythm. 2012; 9: 1524-1576
- Electrical dyssynchrony induced by biventricular pacing: implications for patient selection and therapy improvement.Heart Rhythm. 2015; 12: 782-791
- Permanent His-bundle pacing for cardiac resynchronization therapy: initial feasibility study in lieu of left ventricular lead.Heart Rhythm. 2017; 14: 1353-1361
- His-bundle pacing versus biventricular pacing in cardiac resynchronization therapy patients: a crossover design comparison.Heart Rhythm. 2015; 12: 1548-1557
- Ventricular resynchronization therapy by direct His-bundle pacing using an internal cardioverter defibrillator.Europace. 2013; 15: 83-88
- Pacing and sensing optimization of permanent His-bundle pacing in cardiac resynchronization therapy/implantable cardioverter defibrillators patients: value of integrated bipolar configuration.Europace. 2016; 18: 1399-1405
- Permanent His bundle pacing is an excellent alternative to cardiac resynchronization therapy.Heart Rhythm. 2016; 13 (abstract): S39
- Longitudinal dissociation in the His bundle: bundle branch block due to asynchronous conduction with in the His bundle in man.Circulation. 1977; 56: 996-1006
- Permanent His bundle pacing in advanced AV block. Electrophysiological insights into site of AV block.JACC Clin Electrophysiol. 2015; 1: 571-581
- Atrioventricular conduction system disease.in: Ellenbogen K.A. Wilkogg B.L. Kay G.N. Lau C.P. Auricchio A. Clinical Cardiac Pacing, Defibrillation, and Resynchronization Therapy. Elsevier, Philadelphia, PA2017
Article info
Publication history
Published online: May 12, 2017
Footnotes
Dr. Vijayaraman has been a Speaker and Consultant for Medtronic; and has served on the Advisory Board for Boston Scientific.
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