EP Fellows Curriculum: Physiologic Cardiac Pacing-EP Fellows Curriculum: Physiologic Cardiac Pacing

Video Transcription

Video Summary

Physiologic pacing refers to the utilization of some aspect of the heart's conduction system to achieve a narrow QRS complex. This can be achieved by targeting different areas of the heart's conduction system using pacing leads. The aim is to take advantage of the rapid conduction that occurs when pacing the His-Purkinje system. His bundle pacing is one approach where leads are placed in the His bundle region to achieve QRS narrowing. This can be effective for patients with conditions such as heart block or pacing-induced cardiomyopathy. Left bundle branch pacing is another approach that targets the left bundle branch in order to achieve QRS narrowing. This can be useful for patients with left bundle branch block or right bundle branch block. Both approaches have been shown to improve cardiac function and provide clinical benefits. The mechanisms of QRS narrowing are still not fully understood, but it is thought to involve longitudinal dissociation and recruitment of the intrinsic left conduction system. Physiologic pacing is being increasingly recognized in pacing guidelines and is seen as an important option for many pacing indications. New tools and techniques are being developed to improve the success and outcomes of physiologic pacing.

Keywords

Physiologic pacing

heart's conduction system

narrow QRS complex

pacing leads

His bundle pacing

left bundle branch pacing

QRS narrowing

cardiac function