Rhythm disturbance

Modern pacemakers in use for heart patients

An innovative pacemaker technology stimulates the heart directly via the existing conduction system. This advanced method was successfully applied to an 82-year-old patient at the Wels-Grieskirchen Clinic (Upper Austria). 

The human heart beats according to a certain rhythm, between 50 and 80 times a minute, in order to constantly supply the body with blood. If this does not happen fast enough, a pacemaker is sometimes implanted. The device works like a pacemaker by sending electrical impulses to the heart via one or more electrodes. With each of these impulses, the heart muscle contracts and brings the "life pump" into the right rhythm.

At the end of July 2024, the innovative pacemaker technology "Conduction System Pacing (CSP)" was successfully applied to an 82-year-old patient at the Wels-Grieskirchen Clinic (Upper Austria). This advanced therapy uses the heart's natural conduction pathways to achieve physiological cardiac stimulation.

The innovative CSP pacemaker technology was successfully applied to an 82-year-old patient in the cardiac catheterization laboratory at the Wels-Grieskirchen Clinic (from left to right: DGKP Lisa Zauner, BSc, DGKP Edgar Weissböck, the patient, OA Dr. Peter Huber and Prim. Priv.-Doz. Dr. Ronald Binder)(Bild: Klinikum Wels-Griesirchen)

With conventional pacemaker systems, one or two, in some cases even three electrodes are inserted into the heart via the venous system and the pacemaker unit is implanted under the skin. However, this method carries the risk of delayed excitation of the ventricles, which can increase the risk of heart failure. The volume of blood ejected by the heart is then restricted.

The special feature of 'conduction system pacing' is that the pacemaker directly stimulates the conduction system of the heart.

OA Dr. Peter Huber, Klinikum Wels-Grieskirchen

Bild: Klinikum Wels-Grieskirchen/Nik Fleischmann

Probe directly stimulates the conduction system 
CSP technology, on the other hand, stimulates the heart directly via the existing conduction system. "This makes use of the natural propagation of excitation, which maintains the heart's pumping function and significantly reduces the risk of heart failure," reports Dr. Peter Huber, senior physician at the Department of Internal Medicine II, Cardiology and Intensive Care Medicine at Wels-Grieskirchen Hospital.

The CSP pacemaker probe is screwed into the cardiac septum of the main chambers via the vein using a catheter in a minor procedure. "The procedure is comparable to a conventional pacemaker implantation, but locating the right spot in the heart is a challenge," explains Dr. Huber.

The conduction system consists of very thin heart muscle cells and cannot be visualized using imaging. The optimal location must therefore be found using the electrical currents in the ECG. "If this is fixed, the chances of success are high. If the ideal site cannot be found, it is possible to switch to conventional implantation at any time," says the cardiologist.

Which patients are particularly suitable?
"CSP technology is not necessary for every pacemaker patient," emphasizes Dr. Huber. In many cases, conventional implantation is completely sufficient. CSP technology is particularly suitable for patients in whom a high level of pacing is expected, or in the case of advanced conduction disorders or certain forms of heart failure.