The left bundle-branch block (LBBB) is related to worsening cardiac performance. We describe a case of a patient with an intermittent left bundle-branch block who underwent biventricular pacemaker implantation. We noted a detrimental effect on the performance of her left ventricle with the presence of the LBBB as compared to the performance after she underwent biventricular pacing or after reve...

Cardiac pacing from the right ventricular apex is the most common site of cardiac pacing. During the last decade, several studies demonstrated the harmful effects of the iatrogenic left bundle branch block, which is observed in cardiac pacing from the right ventricular apex. These observations led to an interest in alternative right ventricular pacing sites aiming to achieve a more "physiologic...

Experimental studies have shown that biventricular pacing can improve systolic function in the failing heart with bundle branch block. The goal of this study was to develop and validate a three-dimensional computational model of the dilated failing heart with left bundle branch block to investigate how biventricular pacing can improve systolic mechanical performance and synchrony. In an anatomi...

A patient presented with symptoms of decompensated heart failure 2 months after percutaneous mitral valve (MV) repair. Echocardiography demonstrated impaired left ventricular function with elevated MV pressure gradients and pulmonary pressures during rapid atrial fibrillation. Heart rate control was achieved by implantation of a biventricular pacemaker with subsequent His-bundle ablation becaus...

OBJECTIVES The goal of this analysis was to determine the appropriate biventricular pacing target in patients with heart failure (HF). BACKGROUND Cardiac resynchronization therapy (CRT) decreases the risk of death and HF hospitalization. However, the appropriate amount of biventricular pacing is ill-defined. METHODS Mortality and HF hospitalization data from patients undergoing CRT in 2 tri...

BACKGROUND Cardiac resynchronization therapy has been shown to improve systolic function in patients with advanced chronic heart failure and electromechanical delay (QRS width > 120 ms). However, the effect of acute biventricular (BiV) pacing on perioperative haemodynamic changes is not well defined. In the present study, acute changes in regional left ventricular (LV) systolic function determi...

OBJECTIVES The purpose of this study was to evaluate an implantable cardioverter-defibrillator (ICD) incorporating biventricular pacing. BACKGROUND Biventricular pacing improves the symptoms of heart failure, a frequent problem in ICD recipients. METHODS This prospective multicenter study evaluated the safety and efficacy of an ICD with biventricular pacing. RESULTS A total of 84 patients...

We report a case demonstrating a rapid and potent antiarrhythmic effect of biventricular pacing. A 67-year-old male patient with dilated cardiomyopathy was admitted for heart failure. The initial surface electrocardiogram revealed a left bundle branch block with a QRS complex duration of 200 ms. Echocardiographic examination revealed a left ventricular ejection fraction of 16%, a left ventricul...

Coronary sinus (CS) dissection during biventricular pacing electrode implantation is a complication that rarely develops. A 71-year-old female with recurrent ventricular tachycardia, heart decompensation, and poor left ventricular function because of dilated cardiomyopathy was admitted for the implantation of a cardioverter-defibrillator for biventricular pacing. During the operation, we experi...

Cardiac resynchronization therapy device (CRT-P and CRT-D) implantation has increased tremendously with increasing operator experience, eligible patients and expansion of indications. Refinements in devices and algorithms now aid physicians to improve biventricular pacing and optimize CRT. We report a case in which an interesting device program was used to achieve biventricular pacing after rep...