A Session on Physiologic Pacing and CRT (Joint Session)-A Session on Physiologic Pacing and CRT (Joint Session)

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Video Summary

In the session on heart rhythm innovations, various experts discussed the evolving role of cardiac resynchronization therapy (CRT) and physiologic pacing, with a focus on right bundle branch block (RBBB) patients. Dr. Vy Bodhi analyzed the challenges presented by RBBB, highlighting its association with delayed right ventricular activation and cardiac dyssynchrony, which traditional CRT struggles to address. Physiologic pacing strategies, particularly his-bundle and left bundle branch pacing, were proposed as potentially superior alternatives due to their ability to leverage native conduction pathways, effectively promoting biventricular coordination and potentially improving outcomes.<br /><br />Dr. Srivathsan further explored the technical and physiological aspects of pacing, showing that optimal electrical synchrony is critical and can be better achieved through left bundle branch area pacing, offering significant improvements over traditional biventricular pacing in some cases. He argued for physiologic pacing to become a standard part of CRT implantation strategies.<br /><br />Dr. Jacqueline Joseph raised points about the practical challenges and limitations of physiologic pacing, particularly left bundle branch pacing, in clinical settings, emphasizing the continued need for CRT in certain complex heart failure cases. Despite advances, limitations in current technology and procedural difficulties remain significant hurdles.<br /><br />Dr. Pugal Vijayaraman countered with supporting data for physiologic pacing, arguing that it can significantly enhance patient outcomes by achieving more natural heart contractions. He noted that various pacing strategies should be selected based on specific patient needs, indicating a pragmatic approach towards merging traditional and cutting-edge techniques.<br /><br />Overall, the session underscored an ongoing debate between using advanced physiologic pacing versus traditional CRT methods, with consensus on the need for more research to optimize personalized treatment strategies for heart failure patients with conduction disorders.

Keywords

heart rhythm innovations

cardiac resynchronization therapy

physiologic pacing

right bundle branch block

RBBB

his-bundle pacing

left bundle branch pacing

biventricular coordination

electrical synchrony

heart failure

personalized treatment