CRT and Conduction System Pacing: Clinical Scenarios-CRT and Conduction System Pacing: Clinical Scenarios

Video Transcription

Video Summary

The session explored the role and outcomes of cardiac resynchronization therapy (CRT) and conduction system pacing among patients in various scenarios. Topics included pacing-induced cardiomyopathy and the implications of physiological pacing on cardiac function. Presenters discussed studies and findings on left bundle branch area pacing, particularly focusing on patients with unique conditions such as cardiac sarcoidosis and non-ischemic cardiomyopathy with septal scarring. <br /><br />Physiological pacing techniques, such as his bundle and left bundle branch area pacing, emerged as promising alternatives to traditional ventricular CRT due to potential benefits like reduced QRS duration and improved ventricular activation times. It was noted that these techniques could mitigate issues like pacing-induced cardiomyopathy by maintaining better synchrony in heart function.<br /><br />Research findings highlighted that the presence of septal scar could negatively impact the clinical outcomes of left bundle branch pacing. This underscores the importance of conducting pre-procedural evaluations to better identify patient suitability and anticipate response to pacing therapy.<br /><br />Additionally, a study on tricuspid regurgitation after CRT using left bundle branch area pacing versus biventricular pacing indicated that patients receiving left bundle pacing experienced a worsening of tricuspid regurgitation, suggesting an area needing further clinical evaluation.<br /><br />The session encouraged the use of advanced imaging and mapping technologies to guide implantation and evaluate pacing outcomes, emphasizing individualized patient assessments to improve therapy success rates and patient outcomes in CRT procedures.

Keywords

cardiac resynchronization therapy

conduction system pacing

pacing-induced cardiomyopathy

physiological pacing

left bundle branch area pacing

cardiac sarcoidosis

non-ischemic cardiomyopathy

septal scarring

tricuspid regurgitation

advanced imaging