Left Bundle Branch Block

ABCHF

Review Article

Conduction System Pacing: Redefining Resynchronization Therapy in Heart Failure

Caique M. P. Ternes et al. André Zimerman

Abstract

Cardiac resynchronization therapy is a foundational treatment in patients with heart failure with reduced ejection fraction (HFrEF) and left bundle branch block (LBBB). Although resynchronization has traditionally been performed via biventricular pacing, this approach may be limited by a high rate of non-responders and elevated cost. Conduction system pacing, sometimes referred to as “physiologic” pacing, involves direct stimulation of the heart’s intrinsic conduction pathways and has emerged as a promising alternative. Large intercontinental registries have supported the safety of conduction system pacing in different settings, with high procedural success and low complication rates that are comparable to biventricular pacing. Moreover, in small, randomized trials, conduction system pacing has led to similar or greater improvements in left ventricular ejection fraction and QRS duration versus biventricular pacing, potentially at a lower cost. Ongoing cardiovascular outcomes trials are expected to conclusively determine the role of conduction system pacing in the management of patients with HFrEF and LBBB.

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ABCHF

Review Article

Conduction Disturbances Leading to Heart Failure – What Clinicians Need to Know

Estêvão Lanna Figueiredo et al. Frank Nunes Fernando Carvalho Neuenschwander Kleisson Antônio Pontes Maia André Assis Lopes do Carmo

Abstract

Recently, pre-excitation syndromes, left bundle branch block (LBBB), and right ventricular pacing have been recognized as causes of cardiomyopathies (CMs). They all have abnormal ventricular activation, that results in what is known as left ventricular (LV) dyssynchrony. These three entities show a common feature of wide QRS and LBBB pattern on the electrocardiogram. The term abnormal conduction-induced CM was, then, proposed. Appropriate diagnosis and treatment of these CMs will possibly improve LV ejection fraction, LV functional capacity and reduce morbidity and mortality. In this article we will briefly review these three clinical conditions, aiming to help clinicians to recognize them, manage and refer patients at risk.

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Conduction System Pacing: Redefining Resynchronization Therapy in Heart Failure

Abstract

Conduction Disturbances Leading to Heart Failure – What Clinicians Need to Know

Abstract

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)