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Review
. 2021 Apr;10(1):45-50.
doi: 10.15420/aer.2020.46.

Leadless Left Ventricular Endocardial Pacing and Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy

Baldeep S Sidhu  1   2 , Justin Gould  1   2 , Mark K Elliott  1   2 , Vishal Mehta  1   2 , Steven Niederer  1 , Christopher A Rinaldi  1   2
Affiliations
Review

Leadless Left Ventricular Endocardial Pacing and Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy

Baldeep S Sidhu et al. Arrhythm Electrophysiol Rev. 2021 Apr.

Abstract

Cardiac resynchronisation therapy is an important intervention to reduce mortality and morbidity, but even in carefully selected patients approximately 30% fail to improve. This has led to alternative pacing approaches to improve patient outcomes. Left ventricular (LV) endocardial pacing allows pacing at site-specific locations that enable the operator to avoid myocardial scar and target areas of latest activation. Left bundle branch area pacing (LBBAP) provides a more physiological activation pattern and may allow effective cardiac resynchronisation. This article discusses LV endocardial pacing in detail, including the indications, techniques and outcomes. It discusses LBBAP, its potential benefits over His bundle pacing and procedural outcomes. Finally, it concludes with the future role of endocardial pacing and LBBAP in heart failure patients.

Keywords: Cardiac resynchronisation therapy; WiSE-CRT; endocardial pacing; left bundle branch area pacing.

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Conflict of interest statement

Disclosure: BSS is funded by NIHR and received speaker fees from EBR Systems outside of the submitted work. JG has received project funding from Rosetrees Trust outside of the submitted work. JG, MKE and VM have received fellowship funding from Abbott outside of the submitted work. CAR receives research funding and/or consultation fees from Abbott, Medtronic, Boston Scientific and MicroPort outside of the submitted work. SN has no conflicts of interest to declare. The study was supported by the Wellcome/EPSRC Centre for Medical Engineering (WT203148/Z/16/Z).

Figures

Figure 1:
Figure 1:. Components of the WiSE-CRT System
Figure 2:
Figure 2:. Acoustic Window Screening and WiSE-CRT Implantation
Figure 3:
Figure 3:. Anchoring of the Endocardial Electrode
See this image and copyright information in PMC

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