His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure
Key result
His bundle pacing offers a viable CRT alternative to BiV pacing, overcoming nonresponse by restoring synchrony.
Why the study?
Although biventricular pacing is the primary modality for cardiac resynchronization therapy, nonresponse rates approach 30% to 40%, and His bundle pacing has emerged as a physiological alternative.
Population
Patients with heart failure undergoing cardiac resynchronization
Comparison
His bundle pacing vs biventricular pacing
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“However, HBP failed to exhibit clear advantages in CRT over BiVP due to the low success rates of His corrective pacing (His-SYNC).”
VSVishal S. MehtaCardiologist, Guy's and St Thomas' NHS Foundation Trust
“The Mini Review highlights the results of observation studies showing a 90% success rate of HBP. However, small RCTs in the field showed high crossover rates of up to 48% in HBP groups, which is higher than BVP failure (Upadhyay et al., 2019). In comparison, the relatively high success rate of LBBAP ranging from 80% to 97% is encouraging, alongside observational studies showing better clinical outcomes compared with BVP in patients with LBBB.”
Implication
His bundle pacing may be considered when biventricular pacing fails; small trials with high crossover leave comparative efficacy unresolved.
Abstract
Biventricular pacing (BiV) is established as the primary modality to achieve cardiac resynchronization therapy (CRT), although nonresponse rates approach 30% to 40% [(1)][1]. His bundle pacing has emerged as a viable option for CRT with physiological restoration of electrical synchrony by
Discussion
No takes yet. Share an insight, caveat, or question.
Cite This Study
Upadhyay et al. (2019) studied this question. His bundle pacing is a viable alternative to biventricular pacing for cardiac resynchronization therapy in heart failure, addressing the 30% to 40% nonresponse rate by restoring electrical synchrony.