February 20, 2014

St. Elizabeth’s Medical Center Offers a New Approach for Cardiac Pacemaker Implantation

Brighton, MA –St. Elizabeth’s Medical Center’s electrophysiology team recently began to offer direct conduction system pacing, also known as direct left bundle pacing, for people undergoing pacemaker implants. The team was among the first in New England to treat patients using the left bundle pacing, which is an expansion of the revolutionary His bundle pacing.

“We have found the left bundle pacing procedure is technically easier to achieve than His bundle pacing and allows for a broader application of physiologic pacing to avoid cardiac dyssynchrony,” said John “Jack” Wylie, MD, the Director of Electrophysiology for Steward Health Care. “The benefit of using left bundle pacing for our patients who need pacemakers is the potential for more natural electrical activation of their heart than traditional pacemaker lead positioning.”

Cardiac dyssynchrony in the heart’s lower chambers may result over time from a standard pacemaker procedure or underlying problems in the electrical conduction system of the heart. The reasons for dyssynchrony include abnormal conduction of the electrical signals in the heart or in the case of artificial pacemakers – stimulation in the areas far away from the natural conduction pathways. His bundle and its continuation – the left bundle branch – are parts of this natural conduction system. Direct left bundle pacing involves placement of the pacing lead just below the His bundle into a more distal conduction system of the left bundle branch.

St. Elizabeth’s team has recently published their first results in medical journals, including Circulation: Electrophysiology and Heart Rhythm Journal, and has presented them at international symposia.

“We have conducted innovative studies working with computer mapping of the target area to implant the pacing leads, which has resulted in a new method to guide the lead placement,” explained St. Elizabeth’s Medical Center Electrophysiologist Michael Orlov, MD. “This has resulted in new insights into the heart’s electrical system and allows us to place pacemaker leads in the heart more accurately”

For more information about St. Elizabeth’s Medical Center’s Cardiac Arrhythmia Center and electrophysiology services, visit or call 617-789-3187.