Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland; Department of Cardiology and Amsterdam Cardiovascular Sciences (ACS), Amsterdam University Medical Centers (AUMC), Location VU Medical Center, Amsterdam, The Netherlands.
Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland.
Card Electrophysiol Clin. 2022 Jun;14(2):311-321. doi: 10.1016/j.ccep.2021.12.006. Epub 2022 May 23.
Fusion pacing, which exploits conduction via the intrinsic His-Purkinje system, forms the basis of recent cardiac resynchronization therapy (CRT) optimization algorithms. However, settings need to be constantly adjusted to accommodate for changes in AV conduction, and the algorithms are not always available (eg, depending on the device, in case of AV block or with atrial fibrillation). His-optimized cardiac resynchronization therapy (HOT-CRT), and left-bundle branch optimized cardiac resynchronization therapy (LOT-CRT) which combines conduction system pacing with ventricular fusion pacing, provide constant fusion with ventricular activation (irrespective of intrinsic AV conduction). These modalities provide promising treatment strategies for patients with heart failure, especially in those with chronic atrial fibrillation who require CRT (in whom the atrial port is usually plugged and can be used to connect the conduction system pacing lead).
融合起搏利用固有希浦系统的传导，构成了最近心脏再同步治疗（CRT）优化算法的基础。然而，需要不断调整设置以适应 AV 传导的变化，并且并非总是可以使用这些算法（例如，取决于设备，在出现 AV 阻滞或心房颤动的情况下）。希氏束优化心脏再同步治疗（HOT-CRT）和左束支优化心脏再同步治疗（LOT-CRT），将心脏传导系统起搏与心室融合起搏相结合，提供与心室激活的恒定融合（与固有 AV 传导无关）。这些方式为心力衰竭患者提供了有前途的治疗策略，特别是对于需要 CRT 的慢性心房颤动患者（在这些患者中，通常会堵塞心房端口，并可用于连接心脏传导系统起搏导线）。
