Objective:Physiologic cardiac pacing is a novel technique which has been largely popularized in recent decades.His bundle pacing (HBP) has been long considered the most physiologic pacing method;however, with the wide...Objective:Physiologic cardiac pacing is a novel technique which has been largely popularized in recent decades.His bundle pacing (HBP) has been long considered the most physiologic pacing method;however, with the widespread implementation of this method, its disadvantages have become apparent.In this context, left bundle branch pacing (LBBP)-directly engaged in the His-Purkinje system-has been foreseen as the best pacing method to mimic physiologic activation patterns.This review aimed to summarize recent approaches to physiologic cardiac pacing.Data sources:This review included fully peer reviewed publications up to July 2018, found in the PubMed database using the keywords "His bundle branch pacing," "right ventricular pacing," and "physiologic pacing." Study selection:All selected articles were in English, with no restriction on study design.Results:The HBP has been studied worldwide, and is currently considered the most physiologic pacing method.However, it has disadvantages, such as high pacing threshold, unsatisfactory sensing and long procedure times, among others.Although LBBP is theoretically superior to HBP, the clinical relevance of this difference remains under debate, as few large randomized clinical trials with LBBP have been published.Conclusions:Although HBP indeed appears to be the most physiologic pacing method, it has certain shortcomings, such as high pacing threshold, difficult implantation due to specific anatomic features, and others.Further studies are required to clarify the clinical significance of LBBP.展开更多
Desmoplakin(DSP),encoded by the DSP gene,is the main desmosome component and is abundant in the myocardial tissue.There are three DSP isoforms that assume the role of supporting structural stability through intercellu...Desmoplakin(DSP),encoded by the DSP gene,is the main desmosome component and is abundant in the myocardial tissue.There are three DSP isoforms that assume the role of supporting structural stability through intercellular adhesion.It has been found that DSP regulates the transcription of adipogenic and fibrogenic genes,and maintains appropriate electrical conductivity by regulating gap junctions and ion channels.DSP is essential for normal myocardial development and the maintenance of its structural functions.Studies have suggested that DSP gene mutations are associated with a variety of hereditary cardiomyopathy,such as arrhythmia cardiomyopathy,dilated cardiomyopathy(DCM),left ventricular noncompaction,and is also closely associated with the Carvajal syndrome,Naxos disease,and erythro-keratodermia-cardiomyopathy syndrome with skin and heart damage.The structure and function of DSP,as well as the clinical manifestations of DSP-related cardiomyopathy were reviewed in this article.展开更多
基金a grant from the National Natural Science Foundation of Ghina (No.81570220).
文摘Objective:Physiologic cardiac pacing is a novel technique which has been largely popularized in recent decades.His bundle pacing (HBP) has been long considered the most physiologic pacing method;however, with the widespread implementation of this method, its disadvantages have become apparent.In this context, left bundle branch pacing (LBBP)-directly engaged in the His-Purkinje system-has been foreseen as the best pacing method to mimic physiologic activation patterns.This review aimed to summarize recent approaches to physiologic cardiac pacing.Data sources:This review included fully peer reviewed publications up to July 2018, found in the PubMed database using the keywords "His bundle branch pacing," "right ventricular pacing," and "physiologic pacing." Study selection:All selected articles were in English, with no restriction on study design.Results:The HBP has been studied worldwide, and is currently considered the most physiologic pacing method.However, it has disadvantages, such as high pacing threshold, unsatisfactory sensing and long procedure times, among others.Although LBBP is theoretically superior to HBP, the clinical relevance of this difference remains under debate, as few large randomized clinical trials with LBBP have been published.Conclusions:Although HBP indeed appears to be the most physiologic pacing method, it has certain shortcomings, such as high pacing threshold, difficult implantation due to specific anatomic features, and others.Further studies are required to clarify the clinical significance of LBBP.
基金a grant from the Capital’s Funds for Healthlmprovement and Research(No.CRF 2020-2-2062).
文摘Desmoplakin(DSP),encoded by the DSP gene,is the main desmosome component and is abundant in the myocardial tissue.There are three DSP isoforms that assume the role of supporting structural stability through intercellular adhesion.It has been found that DSP regulates the transcription of adipogenic and fibrogenic genes,and maintains appropriate electrical conductivity by regulating gap junctions and ion channels.DSP is essential for normal myocardial development and the maintenance of its structural functions.Studies have suggested that DSP gene mutations are associated with a variety of hereditary cardiomyopathy,such as arrhythmia cardiomyopathy,dilated cardiomyopathy(DCM),left ventricular noncompaction,and is also closely associated with the Carvajal syndrome,Naxos disease,and erythro-keratodermia-cardiomyopathy syndrome with skin and heart damage.The structure and function of DSP,as well as the clinical manifestations of DSP-related cardiomyopathy were reviewed in this article.
