Treatment to restore natural heartbeat may become a reality for heart failure

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WASHINGTON: A new therapy called ‘His bundle’ pacing that engages and restores the heart’s natural physiology could pave the way for more treatment options for heart failure patients who also suffer from electrical disturbances, according to a pilot study.

The study called ‘His SYNC trial’ was published in the Journal of the American College of Cardiology.

Researchers compared the effectiveness of two different cardiac resynchronization therapies, or treatments to correct irregularities in the heartbeat through implanted pacemakers and defibrillators.

The current standard of care, known as biventricular pacing, uses two pacing impulses in both lower chambers, whereas the newer approach, called ‘His bundle’ pacing, attempts to work toward engaging and restoring the heart’s natural physiology. The two approaches have never before been directly compared in a head-to-head clinical trial.

“This is the first prospective study in our field to compare outcomes between different ways to achieve cardiac resynchronization,” said cardiologist Roderick Tung, the Director of Cardiac Electrophysiology and EP Laboratories at the University of Chicago Medicine.

“Through ‘His bundle pacing’, we are trying to tap into the normal wiring of the heart and restore conduction the way nature intended. Previously, we have just accepted that we had to bypass it through pacing two ventricles at a time,” Tung added.

The trial involved 40 adult patients across seven institutions in the Midwest.

Biventricular pacing involves implanting wires, called leads, to simultaneously pace the right and left ventricles of the heart. A pacemaker then sends a timed electric pulse to the two leads with the goal of a synchronized contraction, which closely simulates the heart’s natural heartbeat.

Nevertheless, roughly 30 per cent of patients do not respond to biventricular pacing treatment, which has been shown to improve survival in clinical trials.