Figure 5.

Novel ‘physiologic’ His pacing. (A) The physiologic conduction system, enabling synchronized propagation of the electrical impulse generated by the physiologic “pacemaker” called the sinoatrial node. This conduction system is composed of the His bundle, right and left bundle branches which are located along either side of the inter-ventricular septum, spreading into millions of tiny conductive Purkinje fibers, enabling a synchronized impulse propagation throughout the cardiac cells to result in a synchronized and efficient cardiac mechanical contraction. (B) Comparing the distal location of a conventional right ventricle (RV) lead (---) to a novel His pacing lead (^__). Pacing via conventional RV lead which is positioned close to RV apex (outside the conduction system) causes a desynchronized conduction, while His pacing utilizes the physiological conduction system to ideally synchronize all cardiac cells.