Tag Archives: His-bundle pacing

Dr Paul Foley Introduction 2018 marks the 60-year anniversary of the first patient to receive an implantable battery-powered pacemaker.1 In fact, the earliest recorded description of pacing was in 1882, and now countless lives have been saved by pacemaker technology. Subsequent important developments include the development of the implantable cardioverter defibrillator (ICD) in 1980 and then, more recently, one of the most effective cardiac treatments, cardiac resynchronisation therapy, which was first described in 1984. Exciting and disruptive developments in pacing technology may, potentially, herald a sea change in practice, while historic

Current landscape For 60 years, right ventricular pacing has been the standard of care for patients with bradycardia who require cardiac pacing. However, while right ventricular pacing is very effective in preventing bradycardia, it produces non-physiological ventricular activation. The ventricular activation wave-front proceeds slowly via cell-to-cell conduction from the pacing site within the right ventricle, resulting in electrical dyssynchrony with delayed left ventricular activation. This non-physiological activation may lead to left ventricular impairment.1,2 Furthermore, right ventricular pacing, when delivered to patients with ventric