WHAT WE DO
Conduction System Pacing
Conduction system pacing is a modern technique used to treat patients with heart block or other conduction disorders, where the electrical signals in the heart do not travel normally through the heart’s conduction system. This method aims to more closely mimic the natural pacing of the heart by targeting specific parts of the heart’s conduction system.
How It Works:
In a typical heart, electrical signals start in the sinoatrial (SA) node, travel through the atria, and reach the atrioventricular (AV) node, which then sends signals to the ventricles through the His-Purkinje system (a specialized conduction system that helps the ventricles contract in a coordinated way). In cases of conduction system disease, there may be blockages or delays in the electrical signals, often causing slow heart rhythms or heart block.
Conduction system pacing works by pacing directly at or near the His bundle or the left bundle branch of the conduction system, areas that are responsible for coordinating the contraction of the heart's ventricles.
Types of Conduction System Pacing:
His Bundle Pacing (HBP):
The pacemaker lead is placed near the His bundle, which is located at the junction of the atria and ventricles. This allows for direct stimulation of the His-Purkinje system, which can help restore a more natural and synchronized heart rhythm.
Left Bundle Branch Pacing (LBBP):
A more advanced method where the pacemaker lead is placed in the left bundle branch. This technique can be used to treat patients with more complex conduction disorders, such as those with left bundle branch block, aiming to improve the contraction of the left ventricle.
Benefits of Conduction System Pacing:
- More Physiologic: It mimics the natural conduction system of the heart more closely than traditional pacing, which usually involves placing the pacemaker lead in the right ventricle. This can lead to better synchronization of the heart's chambers.
- Better Synchronization: It may improve the coordination between the atria and ventricles, resulting in better cardiac output, especially in patients with heart failure.
- Reduced Risk of Long-Term Complications: Traditional pacing (right ventricular pacing) can sometimes lead to complications, such as worsening heart failure or the development of further conduction problems. Conduction system pacing may help reduce these risks.
When Is It Used?
Conduction system pacing is particularly useful in patients with atrioventricular (AV) block or bundle branch block who need a pacemaker. It’s especially beneficial for those who have heart failure and would benefit from improved ventricular function and synchronization.
Procedure:
The procedure involves a catheter-based approach, where a small lead is inserted through a vein and positioned at the desired location in the conduction system (either the His bundle or the left bundle branch). The pacemaker then helps regulate the heart’s electrical impulses, preventing the heart from beating too slowly.
In summary, conduction system pacing is a more advanced and natural method for pacing the heart, potentially improving the overall function of the heart and reducing long-term risks associated with traditional pacing methods.
ECG