Physiological pacing: just a lot of buzz or the next paradigm

Singapore medical journal · Jan 2024

Physiological pacing: just a lot of buzz or the next paradigm shift in bradycardia pacing?

Cardiac pacing has been an established therapy for bradyarrhythmia due to sinus or atrioventricular nodal disease since the 1950s. However, contemporary studies have shown that conventional right ventricular pacing (RVP) causes electromechanical dyssynchrony, which can lead to atrial fibrillation, heart failure and even death. ⋯ There has been a shift towards adopting His bundle pacing (HBP) or left bundle branch area pacing (LBBaP) in bradycardia patients worldwide and in Singapore. This review serves to outline the electrophysiological concepts behind CSP and illustrate the different paced electrocardiogram characteristics of HBP, LBBaP and RVP to aid understanding of this revolutionary pacing approach among medical practitioners in Singapore.

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- Kenny Tan, Shonda Ng, David Foo, Li Wei Tan, Xuyan Teoh, and Pow-Li Chia.
- Department of Cardiology, Tan Tock Seng Hospital, Singapore.
- Singapore Med J. 2024 Jan 8.
AbstractCardiac pacing has been an established therapy for bradyarrhythmia due to sinus or atrioventricular nodal disease since the 1950s. However, contemporary studies have shown that conventional right ventricular pacing (RVP) causes electromechanical dyssynchrony, which can lead to atrial fibrillation, heart failure and even death. Recently, the push for a more physiological cardiac pacing has seen a revival in the utilisation and development of conduction system pacing (CSP). There has been a shift towards adopting His bundle pacing (HBP) or left bundle branch area pacing (LBBaP) in bradycardia patients worldwide and in Singapore. This review serves to outline the electrophysiological concepts behind CSP and illustrate the different paced electrocardiogram characteristics of HBP, LBBaP and RVP to aid understanding of this revolutionary pacing approach among medical practitioners in Singapore.Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.

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Physiological pacing: just a lot of buzz or the next paradigm shift in bradycardia pacing?

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