Additional benefits of nonconventional modalities of cardiac resynchronization therapy using His bundle pacing.

Introduction: Dyssynchrony persists in many patients despite cardiac resynchronization therapy (CRT). Aim of this proof-of-concept study was to achieve better CRT, with a QRS approximating the normal width and axis, by using His bundle pacing (HBP) and nonconventional pacing configurations.

Methods And Results: In 20 patients with CRT indications, we performed an acute intrapatient comparison between conventional biventricular (CONV) and three nonconventional pacing modalities: HBP alone, His bundle, and coronary sinus pacing (HBP + CS), and HBP + CS plus right ventricular pacing (TRIPLE).