This review will focus on the feasibility of long term His bundle pacing and its effects on left ventricle (LV) hemodynamics. Compared with right ventricular pacing, His bundle pacing results in a more physiological electro-mechanical activation that contributes to preserve LV function. Moreover some studies showed a similar effect to biventricular pacing in patients with heart failure and left bundle branch block. Recent observations indicate that His bundle pacing should be considered as an optimal site to pace right ventricle in patients who are candidates for cardiac resynchronization therapy.
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