PhD Defence Floor Corine Wilhelmien Maria Salden

Keywords: pacemaker, heart failure, cardiology, conduction disturbances 
 

"New-fashioned Cardiac Pacing: Spring Forward, Fall Back to Nature’s Way"

Proper cardiac pump function requires that all four chambers work together. Various kinds of disturbances in the (rapid) conduction of the electrical stimulus may lead to worsening pump function. This thesis investigated the potential of novel pacemaker therapies to treat these abnormalities. 

Part I of this thesis shows that pacing in or near the rapid physiological conduction system of the heart can avoid or treat timing differences in activation and contraction between right and left ventricle, also improving pump function. Pacing on the left ventricular side of the septum was found to be equivalent to biventricular and His bundle pacing.  

Part II of this thesis shows the impact of disturbances in atrioventricular conduction (first-degree atrioventricular block) that results in a mismatch between atrial and ventricular contraction, leading to impaired ventricular filling and heart failure. This thesis shows that normalizing the atrioventricular conduction time by biventricular pacing can treat this abnormality. Therefore, first-degree atrioventricular block may be a new indication for pacing therapy. 

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