Fischer Alicia Jeanette, Nagarajan Venkat D, Ho Siew Yen, Diller Gerhard-Paul, Ernst Sabine
Department of Cardiology III, Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Albert-Schweitzer-Str. 33, 48149, Münster, Deutschland.
Department of Cardiology, National Heart and Lung Institute, Imperial College, Royal Brompton and Harefield Hospital, London, Großbritannien.
Herzschrittmacherther Elektrophysiol. 2020 Jun;31(2):104-110. doi: 10.1007/s00399-020-00680-0. Epub 2020 May 6.
Long-term right ventricular apical pacing is known to be deleterious for left ventricular function leading to the clinical picture of heart failure with all the possibly associated complications, ranging up to death of the affected patient. This led to the ambition to find alternative pacing sites such as pacing at the right ventricular outflow tract or septal pacing. An attractive alternative is selective His bundle pacing with the goal to use the physiologic His-Purkinje system in order to enable intrinsic conduction and physiologic myocardial contraction. To find and identify the His bundle poses a challenge for operators. For exact endocardial mapping, knowledge of the anatomic landmarks is as important as the ability to evaluate local electrocardiograms. The goal of this review is to characterize the anatomic landmarks to help physicians to identify these precise targets for His bundle pacing.
