Left ventricular septal pacing maintains left ventricular function at levels comparable to sinus rhythm, though it produces less synchronous activation than left bundle branch pacing.
Does left ventricular septal pacing improve physiological ventricular activation and cardiac function compared to traditional pacing methods in patients requiring ventricular pacing?
Left ventricular septal pacing offers a practical and physiologically beneficial alternative to right ventricular pacing, maintaining left ventricular synchrony and function.
Left ventricular septal pacing (LVSP) and left bundle branch pacing (LBBP) have been introduced to maintain or correct interventricular and intraventricular (dys)synchrony. LVSP is hypothesised to produce a fairly physiological sequence of activation, since in the left ventricle (LV) the working myocardium is activated first at the LV endocardium in the low septal and anterior free-wall regions. Animal studies as well as patient studies have demonstrated that LV function is maintained during LVSP at levels comparable to sinus rhythm with normal conduction. Left ventricular activation is more synchronous during LBBP than LVSP, but LBBP produces a higher level of intraventricular dyssynchrony compared to LVSP. While LVSP is fairly straightforward to perform, targeting the left bundle branch area may be more challenging. Long-term effects of LVSP and LBBP are yet to be determined. This review focuses on the physiology and practicality of LVSP and provides a guide for permanent LVSP implantation.
Heckman et al. (Wed,) conducted a review in Interventricular and intraventricular dyssynchrony. Left ventricular septal pacing (LVSP) vs. Left bundle branch pacing (LBBP) was evaluated. Left ventricular septal pacing maintains left ventricular function at levels comparable to sinus rhythm, though it produces less synchronous activation than left bundle branch pacing.