Fixing Cardiac Contraction Using Your Native Electrical System

The most common cause of heart failure is a heart attack, when a blockage in an artery causes irreversible muscle damage.  Medications are the first line of treatment, but two-thirds of patients may not get better using drugs alone.a

Pacemakers are traditionally used to correct abnormal rhythms using tiny electrical pulses to “pace” the heart artificially – the pulses are emitted by an electrode placed on the tip of thin leads that are positioned via a vein into the right side of the heart.  If one of the heart chambers misses a beat or beats too slowly, pulses of low-level electricity are delivered to the heart wall.  Pacing leads to heart muscle contraction through cell to cell conduction rather than through the native wiring of the heart.a

In some heart failure patients, because of slow electrical conduction through diseased heart tissue, the walls of heart beat out of sync.  In these patients we often place  three electrodes in the heart instead of the regular two,  with the extra lead placed in a cardiac vein on the far side of the heart.  By pacing both sides of the heart at the same time, we attempt to return the heart to its original synchronized rhythm.a

Wouldn’t it be great if we could reverse the electrical conduction damage using the natural conduction (electrical) system of the heart rather than using extra hardware???a

Well, now we can!!!a

A new technique –His Pacing– has been developed over the past few years.  The His bundle is a collection of pacing fibers positioned right at the base of  the ventricles of the heart. By attaching a single electrode to the His bundle, we activate the ventricles using the natural wiring system.  It turns out that by using this system we can sometimes see reversal of  conduction damage to the heart and even  improvment of the overall heart function. a

At Hadassah, we are the first center in Israel to utilize this technology and we have taken the leadership role in this new technique.a