Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Strocchi, M; Lee, AWC; Neic, A; Bouyssier, J; Gillette, K; Plank, G; Elliott, MK; Gould, J; Behar, JM; Sidhu, B; Mehta, V; Bishop, MJ; Vigmond, EJ; Rinaldi, CA; Niederer, SA.
His-bundle and left bundle pacing with optimized atrioventricular delay achieve superior electrical synchrony over endocardial and epicardial pacing in left bundle branch block patients.
Heart Rhythm. 2020; 17(11):1922-1929
Doi: 10.1016/j.hrthm.2020.06.028
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- Co-authors Med Uni Graz
- Gillette Karli
- Neic Aurel-Vasile
- Plank Gernot
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- Abstract:
- BACKGROUND: His-bundle pacing (HBP) and left bundle pacing (LBP) are emerging as novel delivery methods for cardiac resynchronization therapy (CRT) in heart failure patients with left bundle branch block (LBBB). HBP and LBP have never been compared to biventricular endocardial (BiV-endo) pacing. Furthermore, there are indications of negative effects of LBP on right ventricular (RV) activation times (ATs), but these effects have not been quantified. OBJECTIVE: The purpose of this study was to compare changes in ventricular activation induced by HBP, LBP, left ventricular (LV) septal pacing, BiV-endo, and biventricular epicardial (BiV-epi) pacing using computer simulations. METHODS: We simulated ventricular activation on 24 four-chamber heart meshes inclusive of the His-Purkinje network in the presence of LBBB. We simulated BiV-epi pacing, BiV-endo pacing with left ventricular (LV) lead at the lateral wall, BiV-endo pacing with LV lead at the LV septum, HBP, and LBP. RESULTS: HBP was superior to BiV-endo and BiV-epi in terms of reduction in LV ATs and interventricular dyssynchrony (P <.05). LBP reduced LV ATs but not interventricular dyssynchrony compared to BiV-epi and BiV-endo pacing. RV latest AT was higher with LBP than with HBP (141.3 ± 10.0 ms vs 111.8 ± 10.4 ms). Optimizing AV delay during LBP reduced RV latest AT (104.7 ± 8.7 ms) and led to comparable response to HBP. In case of complete AV block, BiV-endo septal pacing was equivalent to LBP. CONCLUSION: HBP is superior to BiV-epi and BiV-endo. To achieve comparable response to HBP, AV delay optimization during LBP is required in order to reduce RV ATs.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Bundle of His - physiopathology
- Bundle-Branch Block - physiopathology, therapy
- Cardiac Catheterization - methods
- Cardiac Resynchronization Therapy - methods
- Electrocardiography - administration & dosage
- Endocardium - administration & dosage
- Female - administration & dosage
- Heart Ventricles - physiopathology
- Humans - administration & dosage
- Male - administration & dosage
- Ventricular Function, Left - physiology
- Find related publications in this database (Keywords)
- Cardiac resynchronization therapy
- Heart failure
- Hisbundle pacing
- Left bundle branch block
- Left bundle pacing