Key result
LVSP and LBBP appear to maintain near-physiologic electrical and mechanical LV activation.
Why the study?
Following the recognition of the adverse effects of right ventricular pacing, alternative permanent pacing strategies to maintain synchronous ventricular contraction have been sought.
Left ventricular septal pacing and left bundle branch pacing are promising strategies that maintain near-physiologic left ventricular activation, offering alternatives to right ventricular pacing.
May support left ventricular septal and bundle branch pacing as physiologic alternatives; leaves open need for randomized outcome trials.
Following the recognition of the adverse effects of right ventricular pacing, alternative permanent pacing strategies aiming to maintain a synchronous ventricular contraction have been sought. The quest for the optimal pacing site has recently led to several promising and rapidly emerging new pacing strategies, such as left ventricular septal pacing and left bundle branch pacing. In both animal and human studies, these pacing strategies seem to maintain electrical and mechanical activation of the left ventricle to a (near)physiologic level. However, more studies on the long-term effects of both strategies are needed.
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Rijks et al. (2022) conducted a review in Indications for permanent pacing. Left ventricular septal pacing and left bundle branch pacing vs. Right ventricular pacing was evaluated on Electrical and mechanical activation of the left ventricle. Left ventricular septal pacing and left bundle branch pacing appear to maintain electrical and mechanical activation of the left ventricle to a near-physiologic level.
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