Pacing Options for Heart Failure with Preserved Ejection Fraction (HFpEF): Conduction System, Bachman Bundle, and Beyond!-Pacing Options for Heart Failure with Preserved Ejection Fraction (HFpEF): Conduction System, Bachman Bundle, and Beyond!

Pacing Options for Heart Failure with Preserved Ejection Fraction (HFpEF): Conduction System, Bachman Bundle, and Beyond!

Video Transcription

Video Summary

The discussion revolved around the future of conduction system pacing for heart failure with preserved ejection fraction (HFPEF). Dr. Marcus Meyer highlighted the pathology of HFPEF and the potential of pacing therapies to address it. He discussed how filling pressures increase with age, leading to atrial fibrillation and HFPEF, and how hypertension and obesity contribute to this acceleration. Meyer's research showed increased fibrosis and intracellular calcium augmentation as key factors in HFPEF, influencing heart relaxation processes. He argued that personalized, accelerated physiologic pacing can reduce filling pressures and aid heart remodeling, thereby offering therapeutic benefits. <br /><br />Dr. Randy Nagarkanti elaborated on pacing indications for HFPEF, associating prolonged PR intervals with adverse outcomes, including heart failure and atrial fibrillation. He highlighted pacing's role in correcting atrial synchrony and managing diastolic dysfunction. Dr. Daniel S. Garten explained the technical approaches to pacing, particularly Bachman bundle pacing, which aims to normalize P-wave morphology and reduce atrial fibrillation risk. The session recognized challenges in establishing optimal pacing strategies and stressed the need for further trials like the Elevate HFPEF study to verify these pacing techniques and define patient populations most likely to benefit. The discussion broadly emphasized pacing's potential in managing HFPEF and improving patient outcomes through refined, personalized approaches.

Keywords

conduction system pacing

heart failure

preserved ejection fraction

HFPEF

pacing therapies

atrial fibrillation

hypertension

Bachman bundle pacing

diastolic dysfunction

personalized medicine