Pacing, Defibrillators & Cardiac Resynchronisation Therapy

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A Quick Guide to Paravalvular Leak Closure

Sameer Gafoor, Jennifer Franke, Stefan Bertog, et al

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Asia Pacific Online Symposium on Cardiac Rhythm Management

Dr. John Ip, Dr. Hiro Yamasaki, Prof. Kyoko Soejima et al

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Risk Stratification in Hypertrophic Cardiomyopathy

Alexandros Klavdios Steriotis, Sanjay Sharma,

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Baroreflex Activation Therapy for the Treatment of HFrEF

Faiez Zannad, Jörn Schmitt , Ainhoa Robles Mezcua et al

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Biology of the Sinus Node and its Disease

Moinuddin Choudhury, Mark R Boyett, Gwilym M Morris,

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Syncope in the Elderly

Helen O’Brien, Rose Anne Kenny,

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Asia Pacific Online Symposium on Cardiac Rhythm Management

Shu Zhang, Seow Swee Chong, David O’Donnell et al

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Permanent Pacemaker Implantation after TAVR

Marcel Weber, Jan-Malte Sinning, Christoph Hammerstingl, et al


Cardiac pacing is a well-established therapeutic tool improving the survival and quality of life in patients. Indications for permanent cardiac pacing include sinus node dysfunction, intermittent and incomplete atrioventricular block, and bundle branch block.

Cardiac pacing, in conjunction with beta-blocker therapy, can potentially reduce the risk of bradycardia-dependent QT prolongation, decrease heart-rate irregularities and reduce repolarisation heterogeneity.

Cardiac resynchronisation therapy (CRT) with biventricular pacing is an effective therapy in patients with advanced heart failure (HF) – New York Heart Association (NYHA) Class III or IV, an ejection fraction (EF) 120 ms.

CRT has also been shown to be effective for the prevention of HF in relatively asymptomatic patients with wide QRS. However, CRT is underutilised among eligible patients. Approximately one-third of patients do not respond to CRT due to various factors, including anatomic difficulties and suboptimal lead placement. To increase the effectiveness of CRT, it has been hypothesised that pacing at multiple left ventricular (LV) sites may provide more effective resynchronisation.

In clinical studies, use of MultiPoint pacing in HF patients undergoing CRT has been associated with increased haemodynamic and clinical benefits compared with conventional pacing, particularly in patients with the least improvement from biventricular pacing.

Related Articles


Physiology and Practicality of Left Ventricular Septal Pacing

Luuk Heckman, Justin Luermans, Floor Salden,


Citation: Arrhythmia & Electrophysiology Review 2021; epub ahead of press.

Heart Block Post-TAVR

Anthony J Mazzella, Sameer Arora, Michael J Hendrickson,


Citation: Cardiac Failure Review 2021;7:e12.

The Subcutaneous ICD: A Review of the UNTOUCHED and PRAETORIAN Trials

Ahmadreza Karimianpour, Leah John, Michael R Gold,


Citation: Arrhythmia & Electrophysiology Review 2021;10(2):108–12.

Fusion Pacing for CRT Optimisation

Peter H Waddingham, Pier Lambiase, Amal Muthumala,


Citation: Arrhythmia & Electrophysiology Review 2021;10(2):91–100.