His bundle pacing: rebirth of an important technique for pacing the intrinsic conduction system

In the current issue of Cardiovascular Innovations and Applications (Volume3, Number 1, 2018, pp. pp. 61-71(11); DOI: 10.15212/CVIA.2017.0030, Michael R. Kaufmann, Matthew S. McKillop, Thomas A. Burkart, Mark Panna, William M. Miles and C. Richard Conti from the Department of Medicine, University of Florida, Gainesville, FL 32610, USA consider His bundle pacing; an important technique for pacing the intrinsic conduction system.

Permanent pacemaker implant is a commonly performed cardiac procedure for treatment of bradycardia or conduction system abnormality. With conventional right ventricular (RV) pacing a lead is implanted at the RV apex or on the RV septum. However, RV apical or RV septal pacing causes iatrogenic left bundle-branch block and ventricular dyssynchrony and can lead to adverse cardiac remodeling, a pacing-mediated cardiomyopathy, and congestive heart failure. Alternatively, permanent His-bundle pacing uses the intrinsic rapidly-conducting His-Purkinje system to activate the ventricle, thereby maintaining (or sometimes even restoring) ventricular synchrony. Many patients may derive benefit from permanent His-bundle pacing.


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