Selective versus non-selective his bundle pacing for cardiac resynchronization therapy

Gaurav A Upadhyay; Roderick Tung

doi:10.1016/j.jelectrocard.2016.10.003

Selective versus non-selective his bundle pacing for cardiac resynchronization therapy

J Electrocardiol. 2017 Mar-Apr;50(2):191-194. doi: 10.1016/j.jelectrocard.2016.10.003. Epub 2016 Oct 18.

Authors

Gaurav A Upadhyay¹, Roderick Tung²

Affiliations

¹ The University of Chicago Medicine, Center for Arrhythmia Care, Heart and Vascular Center, Chicago, IL, United States.
² The University of Chicago Medicine, Center for Arrhythmia Care, Heart and Vascular Center, Chicago, IL, United States. Electronic address: [email protected].

PMID: 27890282
DOI: 10.1016/j.jelectrocard.2016.10.003

Abstract

Cardiac resynchronization therapy (CRT) has an established role in the device-based therapy for patients with systolic dysfunction and intraventricular conduction delay, particularly left bundle branch block (LBBB). Recently, His bundle pacing (HBP) has emerged as a viable alternative for resynchronization which can successfully narrow surface QRS and improve mechanical dyssynchrony. The role of selective (i.e., an isoelectric His-paced to QRS interval similar to native HV interval) versus non-selective capture (i.e., engagement of His along with adjacent local myocardial tissue and pseudo-delta wave) and outcome after HBP for resynchronization is not clear. In this article, we review the current literature (case reports and case series) reporting on HBP for resynchronization and comment on favorable predictors of response.

Keywords: Cardiac resynchronization therapy; His bundle pacing; Para-His; Selective and non-selective His capture.

Publication types

Review

MeSH terms

Bundle of His / physiopathology*
Bundle-Branch Block / diagnosis
Bundle-Branch Block / physiopathology*
Cardiac Pacing, Artificial / methods*
Cardiac Resynchronization Therapy / methods*
Electrocardiography / methods*
Evidence-Based Medicine
Humans
Treatment Outcome