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
Haran Burri, Marek Jastrzebski, Pugazhendhi Vijayaraman
His bundle pacing (HBP) is steadily gaining interest for providing physiological cardiac stimulation. Careful analysis of the electrocardiogram (ECG) is crucial to confirm capture of conduction tissue, which is a prerequisite for successful HBP at implantation and follow-up. However, interpretation of the ECG with HBP can be challenging. This review provides the reader with practical guidance on how to best use and troubleshoot the 12-lead ECG for HBP in daily clinical practice.
July 2020: JACC. Clinical Electrophysiology
Weijian Huang, Shengjie Wu, Pugazhendhi Vijayaraman, Lan Su, Xueying Chen, Bingni Cai, Jiangang Zou, Rongfang Lan, Guosheng Fu, Guangyun Mao, Kenneth A Ellenbogen, Zachary I Whinnett, Roderick Tung
OBJECTIVES: The aim of this study was to assess the feasibility and efficacy of left bundle branch pacing (LBBP) using a novel intraseptal technique to deliver cardiac resynchronization therapy (CRT) in patients with left bundle branch block (LBBB) and nonischemic cardiomyopathy. BACKGROUND: His bundle pacing to correct LBBB is a viable alternative approach to achieve CRT but is limited by suboptimal lead delivery and high thresholds. METHODS: This was a prospective, multicenter study performed between June 2017 and August 2018 at 6 centers...
July 2020: JACC. Clinical Electrophysiology
Ronpichai Chokesuwattanaskul, Krit Jongnarangsin
A 59-year-old female underwent a dual-chamber pacemaker implantation for intermittent complete heart block. A baseline electrocardiogram showed normal sinus rhythm with first degree AV block and right bundle branch block. A His bundle lead placement was attempted. An intracardiac electrogram from the His bundle lead demonstrated Atrial-His (AH) and His-ventricular (HV) intervals were 186 and 110 milliseconds (msec), respectively. Pacing was performed from the His bundle lead with a decremental pacing output to assess for the His bundle capture threshold (Figure 1)...
July 21, 2020: Pacing and Clinical Electrophysiology: PACE
Mark K Elliott, Vishal Mehta, Baldeep Singh Sidhu, Steven Niederer, Christopher A Rinaldi
No abstract text is available yet for this article.
July 2020: HeartRhythm Case Reports
Shunmuga Sundaram Ponnusamy, Vanita Arora, Narayanan Namboodiri, Vivek Kumar, Aditya Kapoor, Pugazhendhi Vijayaraman
Cardiac pacing is the only effective therapy for patients with symptomatic bradyarrhythmia. Traditional right ventricular apical pacing causes electrical and mechanical dyssynchrony resulting in left ventricular dysfunction, recurrent heart failure, and atrial arrhythmias. Physiological pacing activates the normal cardiac conduction, thereby providing synchronized contraction of ventricles. Though His bundle pacing (HBP) acts as an ideal physiological pacing modality, it is technically challenging and associated with troubleshooting issues during follow-up...
July 18, 2020: Journal of Cardiovascular Electrophysiology
Amrish Deshmukh, Sudhakar Sattur, R N Tim Bechtol, Luuk I B Heckman, Frits W Prinzen, Pramod Deshmukh
INTRODUCTION: Fusion of left ventricular pacing with intrinsic conduction provides superior resynchronization compared to biventricular pacing. His bundle pacing (HBP) preserves intrinsic conduction and allows for constant fusion with left ventricular pacing. This study evaluated sequential His bundle and left ventricular pacing for cardiac resynchronization therapy (CRT). METHODS: In patients referred for CRT, sequential His bundle and left ventricular pacing was performed when HBP did not correct the QRS...
July 15, 2020: Journal of Cardiovascular Electrophysiology
Michael V Orlov, Ahad Jahangir, Daniel McKelvey, James Armstrong, Mikhail Maslov, A J Monin, Ioannis Koulouridis, David Casavant, John V Wylie
OBJECTIVES: To characterize 3D electro-anatomical mapping (EAM) of the His bundle (HB) region. BACKGROUND: Visualization of selective (S) and non-selective (NS) HB capture areas by EAM has not been described and may help guide HB pacing (HBP). METHODS: EAM was performed via NavX system in 17 pts undergoing HBP. His bundle cloud, S-HB, NS-HB and right bundle (RB) capture areas were mapped. RESULTS: S-HBP areas were identified in 11, NS-HBP in 14, and RB in 11 pts...
July 15, 2020: Journal of Cardiovascular Electrophysiology
Roderick Tung, Gaurav A Upadhyay
Left bundle branch block (LBBB) is associated with improved outcome after cardiac resynchronisation therapy (CRT). One historical presumption of LBBB has been that the underlying pathophysiology involved diffuse disease throughout the distal conduction system. The ability to normalize wide QRS patterns with His bundle pacing (HBP) has called this notion into question. The determination of LBBB pattern is conventionally made by assessment of surface 12-lead ECGs and can include patients with and without conduction block, as assessed by invasive electrophysiology study (EPS)...
June 3, 2020: Arrhythmia & Electrophysiology Review
Serdar Bozyel, Kivanc Yalin, Tumer Erdem Guler, Tolga Aksu
No abstract text is available yet for this article.
July 2020: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Shunmuga Sundaram Ponnusamy, Giridhar Muthu, Mahesh Kumar, Dasarath Bopanna, Vijesh Anand, Surya Kumar
BACKGROUND: His bundle pacing (HBP) has evolved as the most physiological form of pacing but associated with limitations. Recently, left bundle branch pacing (LBBP) is emerging as an effective alternative strategy for HBP. OBJECTIVES: Our study was designed to assess the feasibility, efficacy, electrophysiological parameters, and mid-term outcomes of LBBP in Indian population. METHODS: All patients requiring permanent pacemaker implantation for symptomatic bradycardia and heart failure were prospectively enrolled...
July 4, 2020: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Marina Strocchi, Angela W C Lee, Aurel Neic, Julien Bouyssier, Karli Gillette, Gernot Plank, Mark K Elliott, Justin Gould, Jonathan M Behar, Baldeep Sidhu, Vishal Mehta, Martin J Bishop, Edward J Vigmond, Christopher A Rinaldi, Steven A Niederer
BACKGROUND: His-bundle pacing (HBP) and left bundle pacing (LBP) are emerging as novel delivery methods for cardiac resynchronization therapy (CRT) in heart failure patients with left bundle branch block (LBBB). HBP and LBP have never been compared to biventricular endocardial (BiV-endo) pacing. Furthermore, there are indications of negative effects of LBP on right ventricular (RV) activation times (ATs), but these effects have not been quantified. OBJECTIVE: The purpose of this study was to compare changes in ventricular activation induced by HBP, LBP, left ventricular (LV) septal pacing, BiV-endo, and biventricular epicardial (BiV-epi) pacing using computer simulations...
June 27, 2020: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Adi Lador, Miguel Valderrábano
No abstract text is available yet for this article.
June 2020: HeartRhythm Case Reports
Jinxuan Lin, Yan Dai, Hao Wang, Yuqiu Li, Keping Chen, Shu Zhang
No abstract text is available yet for this article.
June 2020: HeartRhythm Case Reports
Kevin Andrew Smith, Julie Frey, Amber McKenzie, Kyle Hornsby, John Strobel
Painful left bundle branch block syndrome is a rare disorder in which patients develop typical angina-like pain without identifiable ischemia. To date, there have been few published cases of effective treatment. In this case report, we describe successful implementation of His bundle pacing for durable symptom resolution in this disorder.
June 2020: Clinical Case Reports
Erick Jimenez, Nicholas Zaban, Nandita Sharma, Shanti Narasimhan, Chip Martin-Chafee, Jamie L Lohr, Daniel Cortez
Long-term right ventricular pacing is associated with left ventricular dysfunction and cardiomyopathy, particularly in pediatric patients and those with congenital heart disease (CHD). Research has shown that pacing-induced cardiomyopathy can be reversed with nonselective or selective His bundle pacing in adults, however, the information available about the use of this type of therapy in pediatrics and CHD is scarce. We performed a retrospective chart review of all the cases of His or left bundle pacing at the University of Minnesota, division of Pediatric Cardiology from January of 2019 to April of 2020...
June 21, 2020: Pediatric Cardiology
Jose M Moltedo, Mauricio S Abello, David Doiny, Estela Falconi, María G Majdalani, Carlos J Diaz, Guillermo Macias, Christopher S Snyder
OBJECTIVES: The purpose of this study is to assess the prevalence of a His-Atrial-Ventricular (HAV) pattern, i.e. the atrial electrogram following the His bundle -HB- electrogram and preceding the ventricular one, on the catheter placed in the His position in pediatric patients during typical atrioventricular node reentry (AVNRT). MATERIALS AND METHODS: The pediatric electrophysiology databases of two separate institutions were queried for patients with a diagnosis of AVNRT...
June 14, 2020: Indian Pacing and Electrophysiology Journal
Lucía Torres-Quintero, Manuel Molina-Lerma, Eva Cabrera-Borrego, Rocío García-Orta, Luis Tercedor-Sánchez, Miguel Álvarez
No abstract text is available yet for this article.
June 2020: JACC. Clinical Electrophysiology
Pugazhendhi Vijayaraman, Óscar Cano, Jacob S Koruth, Faiz A Subzposh, Sudip Nanda, Jessica Pugliese, Venkatesh Ravi, Angela Naperkowski, Parikshit S Sharma
OBJECTIVES: This study aimed to assess the feasibility and success rates of permanent His-Purkinje conduction system pacing (HPCSP) in patients requiring pacing after transcatheter aortic valve replacement (TAVR). BACKGROUND: TAVR is associated with increased risk for atrioventricular block. HPCSP has the potential to reduce electromechanical dyssynchrony associated with right ventricular pacing. The feasibility and safety of HPCSP in this population are unknown...
June 2020: JACC. Clinical Electrophysiology
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