Conduction System Pacing for Cardiac Resynchronization Therapy

Autores de IIS La Fe

• Óscar Cano Pérez

  Autor

• Javier Navarrete Navarro

  Autor

• Pablo Jover Pastor

  Autor

• Joaquín Osca Asensi

  Autor

• María Teresa Izquierdo De Francisco

  Autor

• Josep Navarro Manchón

  Autor

• Hebert David Ayala More

  Autor

• 

  Luis Vicente Martínez Dolz

  Autor

Grupos

• Grupo de Investigación Clínica y Traslacional en Cardiología

Abstract

Cardiac resynchronization therapy (CRT) via biventricular pacing (BiVP-CRT) is considered a mainstay treatment for symptomatic heart failure patients with reduced ejection fraction and wide QRS. However, up to one-third of patients receiving BiVP-CRT are considered non-responders to the therapy. Multiple strategies have been proposed to maximize the percentage of CRT responders including two new physiological pacing modalities that have emerged in recent years: His bundle pacing (HBP) and left bundle branch area pacing (LBBAP). Both pacing techniques aim at restoring the normal electrical activation of the ventricles through the native conduction system in opposition to the cell-to-cell activation of conventional right ventricular myocardial pacing. Conduction system pacing (CSP), including both HBP and LBBAP, appears to be a promising pacing modality for delivering CRT and has proven to be safe and feasible in this particular setting. This article will review the current state of the art of CSP-based CRT, its limitations, and future directions.

Keywords

• cardiac resynchronization therapy; His bundle pacing; left bundle branch pacing; conduction system pacing