Finding
This is not widely known, probably because of the familiar drawings of the LBB with discrete anterior and posterior fascicles that are useful in describing electrocardiogram
Paper
His‐Bundle Pacing: Full Circle and Maybe a Bull's Eye
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Full text
Semantic ScholarAbstract
In the words of the legendary late John Messenger, pacemakers have evolved from the equivalent of a pirate’s peg leg that simply prevents you from falling down, to a fully articulated prosthesis. Each “ultimate” step has been succeeded by ever more sophisticated devices. Very early attempts at providing atrioventricular synchrony included metal wire connections between atrium and ventricle, and His-bundle pacing with large screwin electrodes. These efforts failed, largely because of poor conductivity, excessive fibrosis, and loss of capture. Early canine studies by Rosenbaum identified a discrete fascicular system in the left bundle branch (LBB). Primate studies by Demetrio Sodi-Pallares indicated a more complex conduction system. Careful dissection of human hearts by Demoulin and Kulbertus1,2 showed that the distal LBB differs among individuals as much as fingerprints. Furthermore, rather than discrete fascicles, the LBB is more fan-shaped with many interconnections. This is not widely known, probably because of the familiar drawings of the LBB with discrete anterior and posterior fascicles that are useful in describing electrocardiogram
Authors
John D. Fisher
Journal
Pacing and Clinical Electrophysiology