Advances in Physiologic Pacing

Physiologic pacing: where pacing mode selection reflects the indication.

Results of recent trials suggest that in patients with left ventricular dysfunction, interventricular synchrony is possibly more important than atrioventricular synchrony. In patients with AV block and conduction system disease, alternatives to right ventricular apical pacing are therefore needed.

A new paradigm for physiologic ventricular pacing.

Clinical trials in patients with pacemakers for sinus node dysfunction or atrioventricular block (AVB) and implantable cardioverter-defibrillators provide increasing evidence showing that desynchronization of ventricular electrical activation and contraction, induced by conventional right ventricular apex (RVA) pacing, is a serious threat for long-term cardiac morbidity and mortality. The risk ...

Who Needs Physiologic Pacing and Why?

Various pacing technologies have been developed during the past 50 years since the first pacemaker was implanted in 1958. Dual-chamber pacing, rate responsiveness, programmable and rate-responsive atrioventricular (AV) intervals, alternative-site pa0cing, and new multichamber pacing devices are all attempts to mimic normal cardiac physiology as much as feasible. The categories of alternative-si...

Clinical advances in diaphragm pacing.

Diaphragmatic pacing is a valuable tool that can significantly benefit certain patients with respiratory insufficiency provided they have an intact phrenic nerve and a functional diaphragm. Careful patient selection is critical to successful long-term results. The main populations that derive benefit from pacing include those with congenital or acquired central hypoventilation syndrome and more...

Physiologic dual chamber pacing in radiation-induced atrioventricular block.