Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou 325000, PR China.
The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, PR China.
Europace. 2020 Dec 26;22(Suppl_2):ii10-ii18. doi: 10.1093/europace/euaa297.
It is well recognized that a high burden of right ventricular pacing results in deleterious clinical outcomes over the long term. His bundle pacing can achieve optimal ventricular synchronization; however, relatively high pacing thresholds, low R-wave amplitudes, and the long-term performance have been concerns. Recently, left ventricular (LV) septal endocardium pacing (LVSP) has demonstrated improved acute haemodynamics. Another novel technique of intraseptal left bundle branch pacing (LBBP) via transvenous approach has been adopted rapidly and has demonstrated its feasibility and effectiveness. This article reviews the clinical application and differences between LVSP and LBBP. Compared with LVSP, LBBP has strict criteria for left conduction system capture and lead location. In addition to LV septal capture it also stimulates the proximal left bundle branch, resulting in rapid and physiological LV activation. With a uniformity and standardization of the implant procedure and definitions, it may be possible to achieve widespread application of this form of physiological pacing.
人们普遍认识到，长期以来，右心室起搏的负担过重会导致不良的临床结局。希氏束起搏可实现最佳的心室同步，但较高的起搏阈值、较低的 R 波幅度和长期性能一直是人们关注的问题。最近，左心室（LV）间隔心内膜起搏（LVSP）已显示出改善的急性血液动力学。另一种通过经静脉途径的间隔内左束支起搏（LBBP）的新型技术已被迅速采用，并已证明其可行性和有效性。本文综述了 LVSP 和 LBBP 的临床应用和差异。与 LVSP 相比，LBBP 对左传导系统捕获和导联位置有严格的标准。除了 LV 间隔捕获外，它还刺激近端左束支，导致 LV 快速和生理激活。随着植入程序和定义的统一和标准化，这种生理性起搏形式可能得到广泛应用。
