What is New in Conduction System Pacing?-What is New in Conduction System Pacing?

Video Transcription

Video Summary

Three studies were presented in this session on the topic of conduction system pacing. The first study by Dr. Anand Ganesan focused on the torque transfer occurring during conduction system pacing. They conducted a preclinical study using an ex vivo model and found that abrupt torque transfer occurred frequently during lead deployment. They observed different behaviors at the lead interface, including endocardial entanglement, endocardial barrier effect, drill effect, and progressive penetration. These findings suggest that there are technical challenges and variability in lead deployment during conduction system pacing and highlight the need for further study in this area.<br /><br />The second study by Dr. Pablo Vega looked at the results of a physiological pacing registry, which included patients receiving conduction system pacing for heart failure treatment. They compared outcomes between left bundle branch pacing and biventricular pacing and found no significant difference in the composite outcome of heart failure-related hospitalization and all-cause mortality between the two groups. However, left bundle branch pacing was associated with shorter procedure and fluoroscopy times, as well as significant improvements in left ventricular ejection fraction and functional class.<br /><br />The third study by Dr. Zhou Haojie examined the long-term clinical outcomes of left bundle branch pacing versus biventricular pacing for heart failure treatment. They reported on real-world experience and found that left bundle branch pacing was associated with similar rates of heart failure hospitalization and all-cause mortality compared to biventricular pacing. Interestingly, left bundle branch pacing was associated with shorter paced QRS duration and higher left ventricular ejection fraction.<br /><br />Overall, these studies provide valuable insights into the use of conduction system pacing for heart failure treatment and highlight the need for further research and clinical follow-up.

Keywords

conduction system pacing

torque transfer

lead deployment

endocardial entanglement

left bundle branch pacing

biventricular pacing

heart failure treatment

procedure time

fluoroscopy time

clinical outcomes