Physiology and Practicality of Left Ventricular Septal Pacing

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Abstract

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.
Original languageEnglish
Pages (from-to)165-171
Number of pages7
JournalArrhythmia & Electrophysiology Review
Volume10
Issue number3
DOIs
Publication statusPublished - 1 Sep 2021

Keywords

  • Left ventricular septal pacing
  • anti-bradycardia pacing
  • cardiac resynchronisation therapy
  • CARDIAC RESYNCHRONIZATION THERAPY
  • FIBER ORIENTATION
  • PUMP FUNCTION
  • DUAL-CHAMBER
  • ACTIVATION
  • CONDUCTION
  • BUNDLE
  • SEQUENCE
  • ATRIAL
  • SYSTEM

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