Physiologic Pacing for the Prevention and Treatment of Heart Failure A State-of-the-Art Review.

Abstract

Permanent pacing from the right ventricular apex can reduce quality of life and increase the risk of heart failure and death. This review summarizes the milestones in the evolution of pacemakers towards "physiologic pacing" with biventricular pacing systems and lead implantation into the cardiac conduction system to synchronize cardiac contraction and relaxation. Both approaches aim to reproduce normal cardiac activation and help prevent and treat heart failure. This review introduces the basic concepts and clinical evidence and discusses practical uses of physiological pacing.