Key result
His bundle pacing remains a valuable physiological alternative and rescue option for failed CRT or LBBAP.
Why the study?
After being overshadowed by left bundle branch area pacing, it was unclear whether His bundle pacing maintains advantages over LBBAP and what its current uses may be.
Does His bundle pacing offer advantages over left bundle branch area pacing?
Does His bundle pacing offer advantages over left bundle branch area pacing?
His bundle pacing remains a relevant physiological pacing method and should be maintained as an active program in modern pacing laboratories, particularly as a rescue option for failed CRT or LBBAP.
Supports maintaining active His bundle pacing programs; leaves open prospective comparisons to left bundle branch area pacing.
Soon after the rapid growth of the popularity of His bundle pacing (HBP), the use of this conduction system pacing modality was overshadowed by left bundle branch area pacing (LBBAP). This focused review on HBP addresses whether there are any advantages of HBP over LBBAP and what the current uses of HBP may be. We conclude that HBP must be considered as an alternative physiological pacing method with several potential applications, undoubtedly at least as a rescue option for failed CRT/LBBAP. For wider application of HBP, prospective studies are needed to document a reduction in the incidence of late threshold rise with modern implantation techniques. Nevertheless, HBP should be available in every modern pacing laboratory. This requires an active HBP program to maintain and develop the ability of operators to deliver HBP when it is most needed.
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Jastrzębski et al. (2025) conducted a review in Conduction system disease and heart failure. His bundle pacing (HBP) vs. Left bundle branch area pacing (LBBAP) was evaluated. His bundle pacing remains a valuable alternative physiological pacing method and an essential rescue option for failed cardiac resynchronization therapy or left bundle branch area pacing.
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