Minimizing hardware using physiological conduction system pacing: A case

Abstract

Ventricular activation via the specialized His Purkinje system results in synchronous bi-ventricular contraction with an endocardial to epicardial activation wavefront. Biventricular (BiV) pacing for cardiac resynchronization therapy (CRT) often results in a non physiological bi-ventricular activation. Furthermore, LV lead implantation may be challenging due to anatomical constraints. Physiological pacing i.e. Permanent His Bundle pacing (HBP)/Left bundle branch pacing (LBBP) provides an alternative to BiV pacing for these patients. In this report, we present the case of CRT with physiological pacing while minimizing hardware using a dual chamber ICD system.

Keywords

• Physiological pacing
• HBP
• LBBP
• Hardware
• AICD
• CRTD