New way to install pacemakers mimics body's natural rhythm

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When hearts don't beat the way they should, cardiologists insert pacemakers. But now there's a new and different way to place them into the heart, called HIS bundle pacing.

University of South Florida retired cardiologist Peter O. Knight, M.D. was one of the first in Tampa to receive the alternative lead placement three years ago after experiencing stroke-like symptoms.

"I had trouble speaking and I couldn't read what I was reading, didn't last long, went to the E.R. and worked me up and couldn't find anything," Knight recalled.  

A heart monitor later found the source. 

"It didn't take long to figure out what I had. My heart was slowing down very much; I had a block."

Heart blocks put people at risk for sudden death and are often treated with pacemakers.

Pacemakers send impulses to the heart through tiny wires placed in the cardiac muscle.

With HIS bundle pacing, the wires are instead delicately threaded into the part of the heart where the natural pacemaker is located.    

"These conduction fibers are extremely thin, small little fibers probably measuring 1 to 2 millimeters in diameter, so it's especially challenging to screw in leads into this specialized conduction system," explained Dr. Bengt Herweg.

Herweg, also from USF Health, is Knight's former colleague. He specializes in heart rhythm problems and is Knight's doctor.

Because the impulses from the HIS bundle wires trigger a more physiological contraction, studies show the heart pumps more efficiently, reducing the chance of heart failure in the future. 

An added bonus is that it also preserves the natural waveform on the electrocardiogram. That's beneficial when interpreting stress tests and diagnosing other heart problems.

Tampa General Hospital has used the technique in about 150 cases so far and plan even more.

"Now, currently, we are considering it for almost every patient who receives a pacemaker here," Herweg said. "I believe his bundle pacing will revolutionize the whole world of cardiac pacing."

Knight says he's back to his active lifestyle, including ballroom dancing with his wife and spin class at the gym.

"It's brought me back to basically what I had before all this stuff happened," added Knight.