OBJECTIVES Right ventricular (RV) pacing induces a left bundle branch block pattern on ECG and may promote heart failure. Patients with dual chamber pacemakers (DCPs) who present with progressive reduction in left ventricular ejection fraction (LVEF) secondary to RV pacing are candidates for cardiac resynchronization therapy (CRT). This study analyzes whether upgrading DCP to CRT with the addit...

OBJECTIVES The Homburg Biventricular Pacing Evaluation (HOBIPACE) is the first randomized controlled study that compares the biventricular (BV) pacing approach with conventional right ventricular (RV) pacing in patients with left ventricular (LV) dysfunction and a standard indication for antibradycardia pacing in the ventricle. BACKGROUND In patients with LV dysfunction and atrioventricular b...

BACKGROUND Resynchronization pacing is an effective symptomatic treatment for heart failure patients with prolongation of the QRS duration (QRSd). Dyssynchronous contraction of the left ventricle is also observed with normal QRSd. We set out to determine how electrical activation of the left ventricular (LV) free wall differed between patients with left bundle-branch block (LBBB) and normal QRS...

Cardiac resynchronization therapy (CRT) with biventricular pacing (BVP) is well-established in patients reduced left ventricular ejection fraction (LVEF), heart failure and wide QRS or indication for pacing. BVP achieves CRT through non-physiological fusion of paced wave-fronts from the RV endocardium LV epicardium. Conduction system utilizing bundle branch area has recently shown to be a safe ...

Aims A left bundle-branch block (LBBB) ECG type may be caused by either a block in the left branch of the ventricular conduction system or by uncoupling in the working myocardium. We used a realistic large-scale computer model to evaluate the effects of uncoupling with and without left-sided block and in combination with biventricular pacing. Methods and results Action potential propagation was...

BACKGROUND Atrioventricular (AV) delay optimization may be important in patients with biventricular pacing and the optimal AV delay can be predicted using Doppler echocardiography and the formula: optimal AV delay = AV delay-the interval between the end of A wave and complete closure of the mitral valve when the AV delay is set at slightly prolonged AV delay. METHODS AND RESULTS In the presen...

The beneficial use of biventricular pacing is reported in a patient with end-stage hypertrophic cardiomyopathy, intraventricular conduction delay and echocardiographic evidence of intraventricular dyssyncrony. Marked improvement in clinical status, left ventricular ejection fraction and peak VO2 were observed. As far as we know, this is the first report of a beneficial effect of a biventricular...

Permanent His-bundle pacing (HBP) is a true physiological form of ventricular pacing that has been shown in recent years to be both safe and feasible in clinical practice. However, there are limited data about its long-term performance, especially when compared with both right ventricular and biventricular pacing. In this article, we present a thought-provoking case study that illustrates the u...

Currently, most of the time spent caring for the patients with permanent pacemaker will be concerned with evaluating the function of the previously implanted pacing system. Pacing system malfunction can be secondary to pacemaker circuitry failure or to lead dysfunction. Various tools are available to help evaluation of the pacing system malfunction, including physical examination, standard 12-l...