Sati Patel, Khaled Jamoor, Arfaat Khan, Waddah Maskoun
Transcatheter aortic valve replacement (TAVR) is a rapidly growing procedure. Conduction disease post TAVR is frequent and routinely monitored for peri-procedurally. Permanent pacemaker placement is relatively common and usually associated with worse outcomes post TAVR. We report a case of very late presenting complete heart block post TAVR treated with His pacing. Our case underscores the need for larger studies to further evaluate the utility of long-term cardiac monitoring post TAVR and outcomes of His bundle pacing in this population...
September 17, 2020: Pacing and Clinical Electrophysiology: PACE
Min Gu, Hongxia Niu, Yiran Hu, Xi Liu, Nixiao Zhang, Minsi Cai, Xuhua Chen, Xiaohong Zhou, Michael R Gold, Wei Hua, Shu Zhang
Background - His bundle pacing (HBP) is the most physiologic pacing modality. However, HBP has longer procedure times with frequent high capture thresholds, which likely contributes to the low adoption of this approach. The aim of this study is to compare HBP implantation with a novel imaging technique versus the standard implantation technique. Methods - This study included 50 patients with standard pacing indications randomized to HBP with visualization of the tricuspid valve annulus (TVA, N=25, the visualization group) or with the standard method (N=25, the control group)...
September 10, 2020: Circulation. Arrhythmia and Electrophysiology
Gaku Izumi, Hisashi Yokoshiki, Atsuhito Takeda
A 2-year-old male with right isomerism was referred for supraventricular tachycardias. Atrial pacing study revealed that anterograde conduction was only through the posterior atrioventricular node. During the mapping of ventriculoatrial conduction, we identified a sharp potential resembling a His-bundle electrogram with a decremental property at the anterior wall of the common atrium. Catheter ablation for the potential eliminated the anterior ventriculoatrial conduction, thereby indicating retrograde activation of the possible anterior atrioventricular node...
September 9, 2020: Cardiology in the Young
Song-Yun Chu, Qin-Hui Sheng, Er-Dong Chen, Han Jin, Jie Jiang, Yu-Ling Wang, Peng-Kang He, Jing Zhou, Yan-Sheng Ding
In patients with preserved ejection fraction or right bundle branch block (RBBB) pattern requiring a high percentage of ventricular pacing, His-bundle pacing (HBP) might be an alternative to biventricular pacing, although the high threshold occasionally occurs. We provided a case of the intrinsic RBBB correction by capturing intra-Hisian left bundle branch (LBB) or distal His-bundle with different output settings. LBB pacing had the advantage of a much lower threshold while remained most synchrony as HBP. LBB pacing might be a promisingly safe and effective procedure for patients with high-grade atrioventricular (AV) block and RBBB pattern...
September 8, 2020: Annals of Noninvasive Electrocardiology
Yuanjun Sun, Xiaohong Yu, Xianjie Xiao, Xiaomeng Yin, Lianjun Gao, Rongfeng Zhang, Shiyu Dai, Nan Wang, Duoduo Zhang, Yingxue Dong, Yanzong Yang, Yunlong Xia
BACKGROUND: Atrioventricular node (AVN) ablation combined with His bundle pacing is an effective strategy for permanent atrial fibrillation (AF) with rapid ventricular rate refractory to pharmacological therapy. We aimed to access the feasibility and efficiency of His bundle pacing and AVN ablation guided by three-dimensional (3-D) mapping system throughout the procedure. METHODS: 18 patients with permanent AF with refractory rate and symptoms were referred for His bundle pacing and AVN ablation guided by 3-D mapping (CARTO3)...
September 8, 2020: Pacing and Clinical Electrophysiology: PACE
Fouad Khalil, Freddy Del-Carpio Munoz, Abhishek Deshmukh, Ammar M Killu
Providers should be aware of the possibility of cardiac resynchronization therapy-related proarrhythmia which could be life-threatening. His-bundle pacing may serve as an alternative, more physiological, option in the management as it preserves the normal sequence of depolarization from the septum to the lateral wall, and from endocardium to epicardium.
August 2020: Clinical Case Reports
Denghong Zhang, Xiaoming Huang
INTRODUCTION: Substantial advances in cardiac pacing technology have been developed in the past decades. However, efforts to improve pacing technology to achieve physiological electrical activity, such as with cardiac resynchronization therapy, are underway. Permanent His bundle pacing, which directly stimulates the His-Purkinje network and electrically activates both ventricles, simulates physiological electric activity in the heart, and has been considered an ideal pacing strategy to treat arrhythmias...
August 14, 2020: Medicine (Baltimore)
Nadine Ali, Mathew Shun Shin, Zachary Whinnett
PURPOSE OF REVIEW: The aim of cardiac resynchronization therapy (CRT) is to improve cardiac function by delivering more physiological cardiac activation to patients with heart failure and conduction abnormalities. Biventricular pacing (BVP) is the most commonly used method for delivering CRT; it has been shown in large randomized controlled trials to significantly improve morbidity and mortality in patients with heart failure. However, BVP delivers only modest reductions in ventricular activation time and is only beneficial in patients with prolonged QRS duration...
August 28, 2020: Current Heart Failure Reports
Amal Muthumala, Pugazhendhi Vijayaraman
His-Purkinje conduction system pacing (HPCSP) in the form of His bundle pacing (HBP) and left bundle branch pacing (LBBP) allows normal left ventricular activation, thereby preventing the adverse consequences of right ventricular pacing. HBP has been established for several years with centers from China, Europe, and North America reporting their experience. There is international guidance as to how to implant such systems with the differing patterns of His bundle capture clearly described. LBBP is a more recent innovation with potential advantages including improved pacing parameters...
August 27, 2020: Pacing and Clinical Electrophysiology: PACE
Peng Qi, Xue-Xun Li, Ying Tian, Liang Shi, Yan-Jiang Wang, Xing-Peng Liu
A 70-year-old woman with symptomatic bradycardia caused by persistent atrial fibrillation and atrioventricular block was referred to our institution for pacemaker implantation. After we failed to obtain adequate His bundle capture thresholds (>2.5 V at 1.0 ms) at three pacing sites, left bundle branch pacing was attempted as an alternative technique. The tip of the 3830 lead was screwed towards the left side of the interventricular septum. Contrast medium was injected through the C315 sheath, which was placed close to the right side of the interventricular septum to determine the exact depth of the 3830 lead inside the septum...
August 2020: Journal of International Medical Research
Jarosław Bis, Kinga Gościńska-Bis, Rafał Gardas, Łukasz Morkisz, Radosław Gocoł, Adam Kowalówka, Krzysztof S Gołba, Marek A Deja
No abstract text is available yet for this article.
August 14, 2020: Kardiologia Polska
Guram Imnadze, Pugazhendhi Vijayaraman, Hendrik Bante, Thomas Eitz, Leonard Bergau, Nafilah Baridwan, Mustapha El Hamriti, Stephan Molatta, Martin Braun, Moneeb Khalaph, Christian Sohns, Philipp Sommer
AIMS: Pacing the specific conduction system like the Bundle of His (HB) can lead to more physiologic activation patterns compared to traditional right ventricular apical pacing. The aim of this study was to estimate the feasibility and value of electroanatomical mapping (EAM) for HB pacing during the learning curve and its impact on procedural outcome. METHODS AND RESULTS: Fifteen consecutive patients were treated using EAM of the His bundle region before implantation...
August 10, 2020: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Catalin Pestrea, Alexandra Gherghina, Florin Ortan, Gabriel Cismaru, Rosu Radu
INTRODUCTION: Pacing of the His bundle and conduction system seems an attractive site for pacing. Lead placement in His-pacing might be technically challenging due to surrounding structures and particular anatomic location. PATIENT CONCERNS: A 62-years old male patient was admitted for recurrent syncope. Electrocardiographic monitoring revealed periods of complete atrioventricular block with left branch block morphology and a QRS duration of 160 ms. DIAGNOSIS: A diagnosis of intermittent complete atrioventricular block was made with a Class I indication of permanent dual-chamber cardiac pacing...
August 7, 2020: Medicine (Baltimore)
Catalin Pestrea, Alexandra Gherghina, Florin Ortan, Gabriel Cismaru, Rosu Radu
INTRODUCTION: Recent studies have shown that His-bundle pacing could be an alternative in patients requiring cardiac resynchronization therapy as it is comparable or better in terms of amelioration of ventricular activation, narrowing of the QRS complex, or clinical outcomes. However, in case of high threshold at the level of His-bundle or inability to correct conduction through a diseased His-Purkinje system other option should be searched like left bundle pacing. PATIENT CONCERNS: A 77-year-old man presented to the Emergency Department for dizziness and dizziness and lightheadedness due to an intermittent 2:1 atrioventricular block with a QRS complex morphology of a major left branch block...
August 7, 2020: Medicine (Baltimore)
V S Prakash, Anupama V Hegde, U M Nagamalesh, S Ramkumar, Y Sai Krishna, Varsha Rakshitha Prakash, Archana Ratna Potluri
BACKGROUND: Long term right ventricular pacing can have deleterious effects on left ventricular (LV) function. His bundle pacing (HBP), a novel procedure can probably circumvent this setback. We investigated if (1) HBP is associated with pacing induced LV dysfunction by using LV global longitudinal strain (GLS) and (2) intermediate term performance of the Select Secure (3830) lead in the His bundle location. This report is probably the first on HBP in the Indian population. METHODS: 61 patients, with normal LV ejection fraction (EF) with a guideline based indication for permanent pacing underwent a HBP pacemaker implantation using the His Select Secure 3830 lead; with lead guided mapping for locating the His bundle...
May 2020: Indian Heart Journal
Jinlei Qi, Xinwei Jia, Zhanqi Wang
BACKGROUND: Permanent His bundle pacing has been to shown to be an alternative for the patients with CRT indications and more recently has been evaluated for feasibility as a first-line strategy. Data on His bundle pacing (HBP) for cardiac resynchronization therapy are largely limited to small single-center reports, and clinical benefits and risks have not been systematically examined. The purpose of this study was to systematically review published studies of HBP for cardiac resynchronization therapy and evaluate the feasibility and efficacy of the therapy...
August 3, 2020: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Agnieszka Bednarek, Paweł Moskal, Grzegorz Kiełbasa, Rafał Baranowski, Marek Rajzer, Marek Jastrzębski
No abstract text is available yet for this article.
July 31, 2020: Kardiologia Polska
Pablo Moriña-Vázquez, Maria Teresa Moraleda-Salas, Álvaro Arce-León, Juan Manuel Fernández-Gómez, José Venegas-Gamero
INTRODUCTION: Permanent His bundle pacing (p-HBP) could be an alternative for traditional cardiac resynchronization therapy (CRT), but an important limitation is that p-HBP cannot always correct the left bundle branch block (LBBB). The purpose of this article is to assess electrocardiographic patterns of LBBB that can predict electrocardiographic response (QRS narrowing) to His bundle pacing. METHODS: We designed a prospective descriptive study of patients with LBBB and CRT indication proposed for CRT by p-HBP...
July 28, 2020: Pacing and Clinical Electrophysiology: PACE
Ankur R Shah, Muhammad S Khan, Annie M Hirahara, Matthias Lange, Ravi Ranjan, Derek J Dosdall
Utah Electrode Arrays (UEAs) have previously been characterized and implanted for neural recordings and stimulation at relatively low current levels. This proof-of-concept study investigated the applicability of UEAs in sub-surface cardiac pacing, for the first time, particularly to selectively sense and pace the His-Bundle (HB). HB pacing produces synchronous ventricular depolarization and improved cardiac function. Modified UEAs with sputtered iridium oxide film (SIROF) tips (100 - 150 μm) were characterized for SIROF delamination using an electrochemical impedance spectroscopy (EIS), scanning electron microscopy (SEM), and voltage transient (VT) techniques at various current levels of up to 8 mA for a biphasic pulse with 1 ms duration per phase at 4 Hz...
June 8, 2020: ACS Biomaterials Science & Engineering
Rajeev Singh, Subodh Devabhaktuni, Fatima Ezzeddine, Joel Simon, Kavita Khaira, Gopi Dandamudi
BACKGROUND: Chronic left bundle branch block (LBBB) can lead to LBBB mediated cardiomyopathy from left ventricular dysynchrony. His-bundle pacing (HBP) results in direct electrical synchrony using the native His Purkinje system, providing a novel treatment for this cardiomyopathy. OBJECTIVE: To assess the feasibility of HBP for cardiac resynchronization therapy (CRT) in LBBB mediated cardiomyopathy patients. METHODS: Retrospective database review was conducted on patients who underwent cardiac resynchronization therapy by the HBP capable provider at Indiana University Health and Ezkenazi Hospital from August 2015 to August 2017...
July 26, 2020: Journal of Cardiovascular Electrophysiology
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