Ventricular paced failure to capture8/14/2023 ![]() ![]() Cardiac resynchronization therapy (CRT), via biventricular pacing (BVP), is another pacing modality employed for treatment of HF. However, their long-term outcomes have not been demonstrated to be superior to RVAP ( 5, 6). ![]() Moreover, other ventricular pacing sites, such as the right ventricular septal and right ventricular outflow tract, have been developed and applied to minimize the aforementioned potential adverse outcomes. Traditional right ventricular apical pacing (RVAP) has been widely used for more than half a century, although the approach has been shown to cause electric and mechanical dyssynchrony, which exacerbates the risk of atrial fibrillation (AF), heart failure (HF), and even mortality ( 1– 4). To date, cardiac pacing is the only effective therapy for patients with symptomatic bradycardia. The molecular mechanisms of cardiac conduction disease have not been well-understood. In this review, we discuss the current knowledge of LBBP.Ĭardiac conduction disease is a serious health issue caused by the impairment to the integrity of conduction system. However, the technique's widespread adaptation needs further validation to ascertain its safety and efficacy in randomized clinical trials. Therefore, LBBP may be a potential alternative pacing modality for both RVAP and cardiac resynchronization therapy with HBP or biventricular pacing (BVP). This was previously specifically characterized by narrow paced QRS duration, large R waves, fast synchronized left ventricular activation, and correction of left bundle branch block. Overall, this approach has been found to provide physiological pacing that guarantees electrical synchrony of the left ventricle with low pacing threshold. Results from early clinical studies have demonstrated LBBP's feasibility and safety, with rare complications and high success rate. Recently, the left bundle branch pacing (LBBP), defined as the capture of left bundle branch (LBB) via transventricular septal approach, has emerged as a newly physiological pacing modality. ![]() Although His bundle pacing (HBP) has been widely used as a physiological pacing modality, it is limited by challenging implantation technique, unsatisfactory success rate in patients with wide QRS wave, high pacing capture threshold, and early battery depletion. Therefore, there is a need to develop a physiological pacing approach that activates the normal cardiac conduction and provides synchronized contraction of ventricles. However, traditional right ventricular apical pacing (RVAP) causes electric and mechanical dyssynchrony, which is associated with increased risk for atrial arrhythmias and heart failure. Cardiac pacing is an effective therapy for treating patients with bradycardia due to sinus node dysfunction or atrioventricular block. ![]()
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