TY - JOUR
T1 - His Bundle Pacing
AU - ACC's Electrophysiology Council
AU - Vijayaraman, Pugazhendhi
AU - Chung, Mina K.
AU - Dandamudi, Gopi
AU - Upadhyay, Gaurav A.
AU - Krishnan, Kousik
AU - Crossley, George
AU - Bova Campbell, Kristen
AU - Lee, Byron K.
AU - Refaat, Marwan M.
AU - Saksena, Sanjeev
AU - Fisher, John D.
AU - Lakkireddy, Dhananjaya
N1 - Funding Information:
Dr. Vijayaraman has served as a speaker for and received research support from Medtronic; has served as a consultant for Medtronic, Boston Scientific, and Abbott; and has a patent pending for a His delivery tool. Dr. Chung has received research support from Medtronic, Boston Scientific, and Abbott; and has served on the steering committee for EPIC Alliance and Biotronik (uncompensated). Dr. Dandamudi has served as a speaker for, served as a consultant for, and received research support from Medtronic. Dr. Upadhyay has received research support from Medtronic and Biotronik. Dr. Krishnan has received research support from Abbott; and has served as a consultant for Zoll. Dr. Crossley has served as a speaker for, served as a consultant for, and received research support from Medtronic; and has served as a consultant for Boston Scientific. Dr. Fisher has received research support from Medtronic; has served as a consultant for Medtronic and MDT; and has received fellowship support from Medtronic, Abbott, and Biotronik. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2018 American College of Cardiology Foundation
PY - 2018/8/21
Y1 - 2018/8/21
N2 - Traditional right ventricular (RV) pacing for the management of bradyarrhythmias has been pursued successfully for decades, although there remains debate regarding optimal pacing site with respect to both hemodynamic and clinical outcomes. The deleterious effects of long-term RV apical pacing have been well recognized. This has generated interest in approaches providing more physiological stimulation, namely, His bundle pacing (HBP). This paper reviews the anatomy of the His bundle, early clinical observations, and current approaches to permanent HBP. By stimulating the His-Purkinje network, HBP engages electrical activation of both ventricles and may avoid marked dyssynchrony. Recent studies have also demonstrated the potential of HBP in patients with underlying left bundle branch block and cardiomyopathy. HBP holds promise as an attractive mode to achieve physiological pacing. Widespread adaptation of this technique is dependent on enhancements in technology, as well as further validation of efficacy in large randomized clinical trials.
AB - Traditional right ventricular (RV) pacing for the management of bradyarrhythmias has been pursued successfully for decades, although there remains debate regarding optimal pacing site with respect to both hemodynamic and clinical outcomes. The deleterious effects of long-term RV apical pacing have been well recognized. This has generated interest in approaches providing more physiological stimulation, namely, His bundle pacing (HBP). This paper reviews the anatomy of the His bundle, early clinical observations, and current approaches to permanent HBP. By stimulating the His-Purkinje network, HBP engages electrical activation of both ventricles and may avoid marked dyssynchrony. Recent studies have also demonstrated the potential of HBP in patients with underlying left bundle branch block and cardiomyopathy. HBP holds promise as an attractive mode to achieve physiological pacing. Widespread adaptation of this technique is dependent on enhancements in technology, as well as further validation of efficacy in large randomized clinical trials.
KW - cardiac resynchronization therapy
KW - heart failure
KW - permanent His bundle pacing
KW - right ventricular pacing
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U2 - 10.1016/j.jacc.2018.06.017
DO - 10.1016/j.jacc.2018.06.017
M3 - Review article
C2 - 30115232
AN - SCOPUS:85051030344
SN - 0735-1097
VL - 72
SP - 927
EP - 947
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 8
ER -