Selective vs Exclusive: a matter of clearness in His bundle pacing

2021 ◽  
Author(s):  
Giovanni Coluccia ◽  
Michele Accogli ◽  
Pietro Palmisano
Keyword(s):  
His Bundle ◽  
His Bundle Pacing

scholarly journals Low Fluoroscopy Permanent His Bundle Pacing Using Electroanatomic Mapping

2019 ◽  
Vol 12 (2) ◽  
Author(s):  
Parikshit S. Sharma ◽  
Henry D. Huang ◽  
Richard G. Trohman ◽  
Angela Naperkowski ◽  
Kenneth A. Ellenbogen ◽  
...  
Keyword(s):  
Electroanatomic Mapping ◽  
His Bundle ◽  
His Bundle Pacing

scholarly journals ST-Segment Changes in Stress-Induced Cardiomyopathy and His Bundle Pacing

2021 ◽  
Vol 7 (1) ◽  
pp. 131-133
Author(s):  
James E. Ip ◽  
Steven M. Markowitz
Keyword(s):  
His Bundle ◽  
His Bundle Pacing ◽  
St Segment

The implantation technique in His-bundle pacing: evolution and perspectives

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii3-ii9
Author(s):  
Wei Hua ◽  
Shu Zhang ◽  
Dejia Huang
Keyword(s):  
Implantation Technique ◽  
His Bundle ◽  
His Bundle Pacing

scholarly journals Can permanent His bundle pacing be safely started by operators new to this technique? Data from a multicenter registry

2021 ◽  
Vol 13 (2) ◽  
pp. 233-234
Author(s):  
C. Chaumont ◽  
N. Auquier ◽  
A. Milhem ◽  
A. Mirolo ◽  
A. Al Arnaout ◽  
...  
Keyword(s):  
His Bundle ◽  
His Bundle Pacing ◽  
Multicenter Registry

His-bundle pacing in CHF-patients with narrow QRS and chronic AF – an upgrade from single-chamber to dual-chamber ICD

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Ciesielski ◽  
A Slawuta ◽  
A Zabek ◽  
K Boczar ◽  
B Malecka ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Status ◽  
Chronic Atrial Fibrillation ◽  
Dual Chamber ◽  
Icd Implantation ◽  
Single Chamber ◽  
His Bundle ◽  
His Bundle Pacing ◽  
Short Period

Abstract   A single-chamber ICD is a standard method for primary SCD prophylaxis. In patients with chronic atrial fibrillation it does not contribute to the regularization of heart rate, which is crucial for proper treatment. Moreover, to avoid the deleterious effect of right ventricular pacing only minority of the patients with single chamber ICD get the appropriate, recommended dose of beta-blockers. The aim of our study was to assess the efficacy of direct His-bundle pacing in a population of patients with congestive heart failure and chronic atrial fibrillation using upgrade from single chamber to dual-chamber ICD and atrial channel to perform the His-bundle pacing Methods The study population included 39 patients (37 men, 2 women) aged 67.2±9.3 years, with CHF and chronic AF implanted primarily with single chamber ICD with established pharmacotherapy and stable clinical status. Results The echocardiography measurements at baseline and during follow-up were presented in the table: During short period (3–6 months) of follow-up the mean values of EF and LV dimensions significantly improved. This was also accompanied by functional status improvement. Conclusions His-bundle-based pacing in CHF-chronic AF patients contributes to significant echocardiographic and clinical improvement. Standard single-chamber ICD implantation in CHF-chronic AF patients yields only SCD prevention without influence on remodeling process. The physiological pacing contributes to better pharmacotherapy. Funding Acknowledgement Type of funding source: None

P6547The energy cost of His bundle pacing can be curtailed

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Zanon ◽  
L Marcantoni ◽  
G Pastore ◽  
E Baracca ◽  
C Picariello ◽  
...  
Keyword(s):  
Pulse Duration ◽  
Safety Margin ◽  
Significant Saving ◽  
His Bundle ◽  
His Bundle Pacing ◽  
On Demand ◽  
Mild Reduction ◽  
Ventricular Activation ◽  
The Individual ◽  
Current Drain

Abstract Introduction His bundle pacing (HBP) allows physiological ventricular activation and prevents the electrical and mechanical desynchronization generally induced by myocardial stimulation, which can increase the risk of atrial fibrillation and heart failure. On the other hand, reliable HBP capture often requires higher energy than conventional myocardial pacing. This reduces the expected life of the stimulator and might limit the diffusion of HBP in the clinical practice. Purpose Decreasing HBP current drain by careful management of stimulation safety margin and pulse duration. Methods In 28 patients undergoing DDD pacing with HBP, a third lead was implanted in RV apex to provide back-up pacing on demand. HBP and apical leads were connected, respectively, to the V1 and V2 channels of a 3-chamber stimulator. When HBP was effective, apical sensing occurred within the VV delay and prevented V2 stimulation. In contrast, in case of HBP failure, V2 sensing was missing and apical back-up pacing was promptly delivered at the end of the VV delay. The availability of a back-up pulse on demand allowed reducing the HBP safety margin with no risk. Furthermore, the individual HBP strength-duration curve was derived in the aim of optimizing the Hisian pulse parameters, which are the major determinants of the device current drain. Results Correct back-up inhibition by successful HBP and stimulation in the event of capture loss was achieved in all the patients. The latency from Hisian pacing to apical sensing averaged 96±14 ms. According to the pacemaker counters, no back-up pulse was delivered in daily life in 59% of patients. In the remaining, the prevalence of back-up stimulation never exceeded 15% of paced ventricular cycles. The high HBP threshold was essentially due to an increased rheobase (1.2±0.6 V), while the chronaxie ranged from 0.30 to 0.53 ms in 71% of patients (median 0.44 ms), exceeding 0.6 ms only in 29% of the cases. An average current saving of 5.4±3.0 μA was obtained at the expense of a mild reduction in HBP safety margin (from 1.6±0.2 to 1.4±0.1 times). HBP and apical back-up Conclusions Back-up stimulation on demand is a reliable option to decrease HBP current drain and prolong the stimulator service life with full safety. In most of the cases, significant saving can be achieved by pulse shortening, as the chronaxie time is in the same range as with myocardial stimulation and longer pulses are not required. A pulse duration exceeding 0.6 ms is indicated in less than 1/3 of the implants.

scholarly journals B-AB14-01 LEFT VENTRICULAR ACTIVATION TIME AND PATTERN ARE PRESERVED BY BOTH SELECTIVE AND NON-SELECTIVE HIS BUNDLE PACING

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S27
Author(s):  
Ahran Arnold ◽  
Matthew J. Shun-Shin ◽  
Daniel Keene ◽  
James P. Howard ◽  
Ji-Jian Chow ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Activation Time ◽  
His Bundle ◽  
His Bundle Pacing ◽  
Ventricular Activation

Electrical characteristics of pacing different portions of the His bundle in bradycardia patients

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii27-ii35
Author(s):  
Yiran Hu ◽  
Min Gu ◽  
Wei Hua ◽  
Hongxia Niu ◽  
Hui Li ◽  
...  
Keyword(s):  
Wave Amplitude ◽  
Electrical Characteristics ◽  
Normal Range ◽  
Tricuspid Valve Regurgitation ◽  
His Bundle ◽  
His Bundle Pacing ◽  
Pacing Mode ◽  
Echocardiographic Assessment ◽  
R Wave Amplitude

Abstract Aims His-bundle pacing (HBP) can be achieved in either atrial-side HBP (aHBP) or ventricular-side HBP (vHBP). The study compared the pacing parameters and electrophysiological characteristics between aHBP and vHBP in bradycardia patients. Methods and results Fifty patients undergoing HBP implantation assisted by visualization of the tricuspid valvular annulus (TVA) were enrolled. The HBP lead position was identified by TVA angiography. Twenty-five patients were assigned to undergo aHBP and compared with 25 patients who underwent vHBP primarily in a prospective and randomized fashion. Pacing parameters and echocardiography were routinely assessed at implant and 3-month follow-up. His-bundle pacing was successfully performed in 45 patients (90% success rate with 44.4% aHBP and 55.6% vHBP). The capture threshold was lower in vHBP than aHBP at implant (vHBP: 1.1 ± 0.5 vs. aHBP: 1.4 ± 0.4 V/1.0 ms, P = 0.014) and 3-month follow-up (vHBP: 0.8 ± 0.4 vs. aHBP: 1.7 ± 0.8 V/0.4 ms, P < 0.001). The R-wave amplitude was higher in vHBP than in aHBP at implant (vHBP: 4.5 ± 1.4 vs. aHBP: 2.0 ± 0.8 mV, P < 0.001) and at 3-month follow-up (vHBP: 4.4 ± 1.5 vs. aHBP: 1.8 ± 0.7 mV, P < 0.001). No procedure-related complications and aggravation of tricuspid valve regurgitation were observed in most patients and echocardiographic assessment of cardiac function remained in the normal range in all patients during the follow-up. Conclusion This study demonstrates that vHBP features a low and stable pacing capture threshold and high R-wave amplitude, suggesting better pacing mode management and battery longevity can be achieved by HBP in the ventricular side.

scholarly journals Permanent His-bundle pacing: a systematic literature review and meta-analysis

EP Europace ◽  
2018 ◽  
Vol 20 (11) ◽  
pp. 1819-1826 ◽  
Author(s):  
Francesco Zanon ◽  
Kenneth A Ellenbogen ◽  
Gopi Dandamudi ◽  
Parikshit S Sharma ◽  
Weijian Huang ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
His Bundle ◽  
His Bundle Pacing
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