Pacemakers save lives – especially for people with what is known as AV block. This is a disorder affecting the electrical signals that normally ensure that the heart beats at the right rhythm. In such cases, the pacemaker takes over this task.
Pacemakers: vital, but not without side effects
However, the classic method of stimulation has one disadvantage: the heart muscle is stimulated at a point (the apex of the heart) that deviates from the natural signal transmission. In the long term, this can lead to the two ventricles no longer working together optimally, which weakens the heart's pumping capacity and can cause heart failure (cardiac insufficiency) in the long term.
More natural arousal – better heart function
The new method, known as left bundle branch pacing (LBBAP), mimics the heart's natural signal conduction much more closely. Instead of artificially starting the electrical signal ‘from outside’, the heart's internal conduction system – known as the His-Purkinje system – is specifically activated. In a healthy heart, this system ensures that all heart muscle cells contract at the right moment and that the heart pumps blood efficiently through the body.
‘Conventional stimulation can impair cardiac performance in the long term – especially in patients whose hearts need to be controlled by a pacemaker almost constantly,’ explains PD Dr. Moritz Sinner, cardiologist at the Medical Clinic and Polyclinic I of the LMU Clinic in Munich and one of the scientific directors of the study. ‘The new technology could be a much milder and more effective solution here.’
Strong together – multicentre study involving over 20 clinics
More than 20 clinics throughout Germany are participating in the study. A total of around 200 patients with high-grade AV block – i.e. people who are permanently dependent on a pacemaker – are expected to take part.
PD Dr Florian Blaschke (DHZC) and PD Dr Moritz Sinner (LMU Klinikum München) are sharing the scientific leadership. Charité is also assuming legal responsibility for the project.
‘Such close and productive cooperation between two leading university hospitals is not a matter of course,’ says PD Dr Florian Blaschke. ‘We are so delighted that we are able to advance this important project together in such a focused and committed manner.’
