Is Biventricular Pacing the Best Approach in Heart Failure?

In a small study, His bundle pacing was associated with roughly equivalent outcomes as cardiac resynchronization therapy with coronary sinus leads.

In large randomized, controlled trials, biventricular pacing with cardiac resynchronization therapy (CRT) has reduced hospitalizations and improved mortality in patients with low left ventricular ejection fractions (LVEFs) and widened QRS. Patients with left bundle branch block (LBBB) appear to derive the greatest benefit from CRT.

Theoretically, pacing the His bundle, even in patients with LBBB, has the potential to decrease ventricular dyssynchrony, thus improving symptoms and outcomes in heart failure. Most studies on His pacing have been small and observational, with only one randomized, controlled study of 41 patients being reported. Now, researchers report results on another pilot study of 50 patients, who were randomized to biventricu…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Is Biventricular Pacing the Best Approach in Heart Failure?

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Reviewing Author