Cor Vasa 2022, 64(4):423-435 | DOI: 10.33678/cor.2022.008

(Conduction system pacing, classification, operation techniques, and methods used to confirm ventricular capture type in pacemaker implantation)

Ondřej Süssenbeka, Rostislav Polášekb, Alan Bulavac, Petr Štrosa, Milan Chovanecd, Karol Čurilaa
a Kardiocentrum, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha
b Krajská nemocnice Liberec, a.s., Liberec
c Kardiocentrum, Nemocnice České Budějovice, a.s., České Budějovice, Zdravotně sociální fakulta Jihočeské univerzity v Českých Budějovicích
d Nemocnice Na Homolce, Praha a Ústav fyziologie, 2. lékařská fakulta Univerzity Karlovy v Praze, Praha

New methods of cardiac pacing are being adopted in clinical practice in recent years. They are called physiological pacing or conduction system pacing and include His bundle pacing, direct left bundle branch pacing, and left ventricular septal pacing. These methods differ significantly from a standard pacemaker implant procedure. The lead is fixed directly into or adjacent to the tissue of the conduction system of the heart as opposed to lead fixation in myocardial tissue of the right ventricle. Specialized tools and maneuvers for confirming conduction system capture are necessary during the implant procedure. Growing evidence on the safety and feasibility of these methods is reflected in latest guidelines on cardiac pacing of several national societies. They recommend physiological pacing (mainly His bundle pacing) in some specific indications as an alternative to right ventricular myocardial or biventricular pacing. This review describes types of physiological pacing, implant technique, methods of confirming conduction system capture, and its advantages and disadvantages in patients with bradycardia and indication for pacemaker implantation.

Keywords: Conduction system, His bundle pacing, Left bundle branch pacing, Left ventricular septal pacing, Physiological pacing,

Received: January 7, 2022; Revised: January 7, 2022; Accepted: February 11, 2022; Published: September 1, 2022  Show citation

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Süssenbek O, Polášek R, Bulava A, Štros P, Chovanec M, Čurila K. (Conduction system pacing, classification, operation techniques, and methods used to confirm ventricular capture type in pacemaker implantation). Cor Vasa. 2022;64(4):423-435. doi: 10.33678/cor.2022.008.
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