Lbbb vs ivcd12/23/2023 ![]() ![]() Although His bundle pacing (HBP) has been widely used as a physiological pacing modality, it is limited by challenging implantation technique, unsatisfactory success rate in patients with wide QRS wave, high pacing capture threshold, and early battery depletion. Therefore, there is a need to develop a physiological pacing approach that activates the normal cardiac conduction and provides synchronized contraction of ventricles. However, traditional right ventricular apical pacing (RVAP) causes electric and mechanical dyssynchrony, which is associated with increased risk for atrial arrhythmias and heart failure. PMID 14879494.Cardiac pacing is an effective therapy for treating patients with bradycardia due to sinus node dysfunction or atrioventricular block. "The dissection of the atrioventricular node, bundle and bundle branches in the human heart". "Anatomical configuration of the His bundle and bundle branches in the human heart". "Why does the heart beat? The discovery of the electrical system of the heart". ^ Silverman ME, Grove D, Upshaw CB (June 2006)."Implications of left bundle branch block in patient treatment". ![]() ^ Kumar V, Venkataraman R, Aljaroudi W, et al.Progress in Biophysics and Molecular Biology. "Modelling of the ventricular conduction system". ^ a b Tusscher KH, Panfilov AV (2008)."Remission of left Tawara-branch block under treatment for systemic sarcoidosis". ^ Kullmann T, Baráth Z, Csiszér E (January 2009).Although Tawara's monograph had demonstrated that the branches of the bundle of His may transmit cardiac action potentials to the ventricles, the functional proof for his observation was not provided until 1910, when Hans Eppinger and Carl Julius Rothberger showed that cutting off both branches to induce a bilateral bundle branch block results in a complete heart block. The bundle branches were separately described by Retzer and Braeunig as early as 1904, but their physiological function remained unclear and their role in the electrical conduction system of the heart remained unknown until Sunao Tawara published his monograph on Das Reizleitungssystem des Säugetierherzens (English: The Conduction System of the Mammalian Heart) in 1906. This condition is known as a bundle branch block. When a bundle branch or their fascicles becomes injured (by underlying heart disease, myocardial infarction, or cardiac surgery), it may cease to conduct electrical impulses appropriately, resulting in altered pathways for ventricular depolarization. They play an integral role in the electrical conduction system of the heart by transmitting cardiac action potentials to the Purkinje fibers. These structures lead to a network of thin filaments known as Purkinje fibers. The left bundle branch further divides into the left anterior fascicle and the left posterior fascicle. There are two branches of the bundle of His: the left bundle branch and the right bundle branch, both of which are located along the interventricular septum. They play an integral role in the electrical conduction system of the heart by transmitting cardiac action potentials from the bundle of His to the Purkinje fibers. The bundle branches, or Tawara branches, are offshoots of the bundle of His in the heart's ventricle. ![]()
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