- •Electrical activation of the left ventricle starts in the left bundle branch followed by three endocardial areas at the left side of the interventricular septum.
- •Right ventricular pacing is associated with adverse effects such as heart failure and atrial fibrillation.
- •Left ventricular septal pacing results in (near) physiologic activation of the left ventricle and shows promising results in cardiac resynchronization therapy.
- •Left bundle branch pacing proves to maintain or restore (in LBBB) left ventricular electrical and mechanical synchrony with promising results in cardiac resynchronization therapy.
- •Implantation techniques for LVSP and LBBP are similar, although more advanced electrophysiological knowledge and equipment is needed to verify left bundle branch capture.
- •Theoretically left bundle branch pacing leads to a more synchronous activation of the left ventricle due to capture of the specialized conduction system.
- Burri H.
- Starck C.
- Auricchio A.
- et al.
Physiologic activation of the left ventricle
Adverse effects of right ventricular pacing
Pathophysiology of Right Ventricular Pacing
Clinical Outcomes of Right Ventricular Pacing
Left ventricular septal pacing
Acute Effects of Left Ventricular Septal Pacing
Long-Term Effects of Left Ventricular Septal pacing
Left Ventricular Septal Pacing in the Human Heart
Left Ventricular Septal Pacing in Cardiac Resynchronization Therapy
Left bundle branch pacing
Left Bundle Branch Pacing in Cardiac Resynchronization Therapy
Left ventricular septal pacing or left bundle branch pacing?
Clinics care points
- •LVSP and LBBP result in (near) physiologic electrical and mechanical activation of the left ventricle.
- •Studies regarding CRT show promising results for both LVSP and LBBP.
- •More studies regarding long-term effects of LVSP and LBBP are needed.
- •More studies comparing LVSP and LBBP are needed to further evaluate and compare both pacing strategies.
Conflict of interest
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