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Review
. 2019 Mar 19;8(6):e010972.
doi: 10.1161/JAHA.118.010972.

His Bundle Pacing: A New Strategy for Physiological Ventricular Activation

Andrew J M Lewis  1   2 , Paul Foley  1 , Zachary Whinnett  3 , Daniel Keene  3 , Badrinathan Chandrasekaran  1
Affiliations
Review

His Bundle Pacing: A New Strategy for Physiological Ventricular Activation

Andrew J M Lewis et al. J Am Heart Assoc. .

Erratum in

No abstract available

Keywords: His bundle; pacemaker; resynchronization.

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Figures

Figure 1
Figure 1
ECGs from the same patient demonstrating selective and nonselective ventricular capture according to pacing energy. Selective capture is seen at 4 V at 1 ms while nonselective capture occurs higher output (8 V at 1 ms; note the pseudodelta wave and absence of stimulus‐QRS [S‐QRS] isoelectric interval in nonselective capture). Depending on the lead position and His bundle anatomy, some patients (the majority in many series) will exhibit only nonselective capture regardless of pacemaker output. H‐QRS indicates His electrogram to QRS interval.
Figure 2
Figure 2
Correction of right bundle branch block (RBBB)/left anterior fascicular block (LAFB) with His bundle pacing (HBP) with nonselective capture, also enabling restoration of shorter atrioventricular (AV) conduction. The mechanisms by which HBP is able to correct bundle branch block remain contentious but are thought to include recruitment of fibers distal to the site of delay and improved capture relating to higher pacing output and suggest that bundle branch “block” is relative.
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