Physiologic Pacing Targeting the His Bundle and Left Bundle Branch: a Review of the Literature

Scheetz, Seth; Upadhyay, Gaurav A.

doi:10.1007/s11886-022-01723-3

Cited by 9 publications

(2 citation statements)

References 119 publications

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“…A recent development, His‐Purkinje system pacing (HPSP), offers an alternative to BiVP. HPSP, which includes left bundle branch pacing (LBBP) and His‐bundle pacing (HBP), targets the His‐Purkinje conduction system, providing improved synchronization and need for fewer leads compared to BiVP 5,6 . This meta‐analysis compares the clinical outcomes and benefits of LBBP and HBP with BiVP in systolic HF patients.…”

Section: Introductionmentioning

confidence: 99%

Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis

Al Hennawi,

Khan,

Khalid

et al. 2023

Pacing Clinical Electrophis

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BackgroundThis meta‐analysis compares His‐Purkinje system pacing (HPSP), a novel cardiac resynchronization therapy (CRT) technique that targets the intrinsic conduction system of the heart, with conventional biventricular pacing (BiVP) in heart failure (HF) patients with left ventricular (LV) dysfunction and dyssynchrony.MethodsWe searched multiple databases up to May 2023 and identified 18 studies (five randomized controlled trials and 13 observational studies) involving 1291 patients. The outcome measures were QRS duration, left ventricular ejection fraction (LVEF) improvement, left ventricular end‐diastolic diameter (LVEDD) change, HF hospitalization, and New York Heart Association (NYHA) functional class improvement. We used a random‐effects model to calculate odds ratios (OR), and mean differences (MD) with 95% confidence intervals (CI). We also assessed the methodological quality of the studies.ResultsThe mean LVEF was 30.7% and the mean follow‐up duration was 8.1 months. Among LBBP, HBP, and BiVP, HBP provided the shortest QRS duration [MD: −18.84 ms, 95% CI: −28.74 to −8.94; p = 0.0002], while LBBP showed the greatest improvement in LVEF [MD: 5.74, 95% CI: 2.74 to 7.46; p < 0.0001], LVEDD [MD: −5.55 mm, 95% CI: −7.51 to −3.59; p < 0.00001], and NYHA functional class [MD: −0.58, 95% CI: −0.80 to −‐0.35; p < 0.00001]. However, there was no significant difference in HF hospitalization between HPSP and BiVP.ConclusionLBBP as modality of HPSP demonstrated superior outcomes in achieving electrical ventricular synchrony and systolic function, as well as alleviating HF symptoms, compared to other pacing techniques.

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Section: Introductionmentioning

confidence: 99%

Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis

Al Hennawi,

Khan,

Khalid

et al. 2023

Pacing Clinical Electrophis

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“…HBP, a feasible alternative to CRT, directly paces the His-Purkinje system to activate the ventricles and physiologically achieve synchronous contraction [ 11 , 12 ]. However, its steeper and longer learning curve, higher pacing thresholds, and lower implantation success rates have limited its clinical application [ 13 ]. Therefore, as a novel pacing technology first reported by Huang et al .…”

Section: Introductionmentioning

confidence: 99%

Risk of Atrial Fibrillation Following Left Bundle Branch Area Pacing versus Right Ventricular Pacing and Biventricular Pacing: A Systematic Review and Meta-Analysis

Liu,

Dai,

Lou

et al. 2023

Rev. Cardiovasc. Med.

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Background: Left bundle branch pacing (LBBP) is a relatively novel physiological pacing strategy with better electrocardiogram characteristics and pacing parameters than other pacing strategies. At present, no meta-analysis or systematic review has examined the risk of atrial fibrillation (AF) after LBBP compared to other pacing strategies. Methods: We searched the PubMed, Embase, and Cochrane Library databases from inception through September 18, 2022 to identify relevant studies reporting AF incidence rates after LBBP. The incidence of AF following LBBP and that associated with other pacing strategies were extracted and summarized for the meta-analysis. We used odds ratios (ORs) and 95% confidence intervals (CIs) as summary estimates. Results: Five studies with 1144 participants were included. The pooled rate of AF was 3.7% (95% CI, 0.8%–8.0%) in the LBBP group and 15.5% (95% CI: 9.6%–22.4%) in the other pacing strategies (right ventricular pacing [RVP] and biventricular pacing [BVP]). Compared with other pacing strategies, LBBP was associated with a lower AF risk (OR, 0.33; 95% CI: 0.22–0.51, = 0.0%; p = 0.485). Similar results were observed for LBBP when compared with RVP (OR: 0.33, 95% CI: 0.22–0.51, = 0.0%, p = 0.641) and BVP (OR: 0.47, 95% CI: 0.01–15.22, = 60.4%, p = 0.112). Conclusions: Compared with BVP and RVP, LBBP was associated with a significantly lower risk of AF. However, further large-sample randomized controlled trials are needed to confirm that LBBP is superior to other pacing strategies in reducing AF risk.

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Temporary and Permanent Pacemakers and Automated Internal Defibrillators

Stephenson,

Berul

2023

Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care

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Physiologic Pacing Targeting the His Bundle and Left Bundle Branch: a Review of the Literature

Cited by 9 publications

References 119 publications

Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis

Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis

Risk of Atrial Fibrillation Following Left Bundle Branch Area Pacing versus Right Ventricular Pacing and Biventricular Pacing: A Systematic Review and Meta-Analysis

Temporary and Permanent Pacemakers and Automated Internal Defibrillators

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