Hyper-response to cardiac resynchronization with permanent His bundle pacing: Is parahisian pacing sufficient?

Ajijola, Olujimi A.; Romero, Jorge; Vorobiof, Gabriel; Suh, William M.; Shivkumar, Kalyanam; Tung, Roderick

doi:10.1016/j.hrcr.2015.05.006

Cited by 10 publications

(4 citation statements)

References 14 publications

(28 reference statements)

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“…[10][11][12][13][14] Moreover, patients with a pacemaker indication have shown improved clinical response and greater 5-year survival with PHBP compared to right ventricular (RV) pacing. 15 In patients with heart failure and LBBB, PHBP has been shown to achieve cardiac resynchronization therapy (CRT), 11,[16][17][18][19][20][21] and some investigators have suggested PHBP as first-line therapy. 21,22 Detailed how-to publications 8,9,23 and a recent guidance publication have further contributed to adoption of PHBP use.…”

Section: Introductionmentioning

confidence: 99%

Permanent His-bundle pacing using stylet-directed, active-fixation leads placed via coronary sinus sheaths compared to conventional lumen-less system

et al. 2019

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BACKGROUND The use of coronary sinus (CS) sheaths to deliver stylet-driven leads (SDLs) for His-bundle pacing (HBP) has not been described. Conventionally, HBP is achieved using a styletless lead delivered through a customized catheter. OBJECTIVE The purpose of this study was to characterize the acute and early-term HBP experience with stylet-driven, active-fixation leads delivered through CS sheaths compared to the conventional approach. METHODS Delivery of Medtronic 4471 and 7742 SDLs was attempted in 27 patients. Delivery was facilitated using CS guide catheters and custom-shaped stylets. Procedural characteristics and lead performance were compared to those of a group of 17 patients in whom delivery of 3830 lumen-less leads (LLLs) was attempted. Patients had heterogeneous pacing indications. RESULTS HBP with SDL was successful in 24 of 27 patients(89%) compared to 15 of 17 patients (88%) in the LLL group. Mean procedural and fluoroscopy times in the SDL and LLL groups were 129 6 43 minutes vs 104 6 43 minutes and 9.6 6 5.2 minutes vs 8.3 6 5.0 minutes, respectively (both P 5 NS). There was a significant difference in procedure and fluoroscopy times within the SDL group between the first and second halves of the series, probably secondary to a learning curve. Acute HBP thresholds were higher with SDL than with LLL (2.6 6 1.5 V vs 1.5 6 1.2 V; P 5 .02) and remained stable at 8.4 6 5.3 months. Both SDLs exhibited similar pacing thresholds. Two crossovers between groups occurred (1 in each group). Four patients with SDL and 1 patient with LLL exhibited high thresholds during follow-up. CONCLUSION Permanent HBP using stylet-driven, active-fixation leads delivered through conventional CS sheaths is feasible. Procedural characteristics and lead performance were clinically acceptable.

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Section: Introductionmentioning

confidence: 99%

Permanent His-bundle pacing using stylet-directed, active-fixation leads placed via coronary sinus sheaths compared to conventional lumen-less system

et al. 2019

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“…Dle dosavadních poznatků se zdá, že u většiny nemocných je neselektivní stimulace Hisova svazku spojena s podobnou elektromechanickou a klinickou odpovědí jako stimulace selektivní. [13][14][15] Korekce raménkové blokády pomocí stimulace Hisova svazku by měla představovat nejvíce fyziologický způsob resynchronizační terapie. Oproti biventrikulární stimulaci totiž nespoléhá na endo-či epikardiální stimulaci kardiomyocytů, ale aktivuje nativní převodní systém.…”

Section: Diskuseunclassified

(Super-responder to His-bundle pacing - case report)

Sussenbek¹,

Ionita²,

Rýzlová³

et al. 2020

Cor Vasa

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Prezentujeme případ 62letého pacienta s významně sníženou ejekční frakcí levé komory srdeční, u kterého byla indikována resynchronizační terapie pro srdeční selhání. Resynchronizace bylo dosaženo pomocí stimulace Hisova svazku. Po šesti týdnech od zákroku došlo u pacienta k vymizení symptomů srdečního selhání a značnému zlepšení echokardiografi ckých parametrů. Korekce blokády levého Tawarova raménka stimulací Hisova svazku u tohoto pacienta zásadně ovlivnila další průběh onemocnění.

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“…41 Improvements in left ventricular ejection fraction and symptoms have been observed with His pacing. 31,42,43 His pacing was initially assessed as a rescue strategy in cases where biventricular pacing failed, 29,32 and some authors have shown that His pacing is feasible as a primary strategy for cardiac resynchronisation. 30 In a crossover study, His pacing was more effective than biventricular pacing at reducing QRS duration in 72 % of patients (21/29) This shortening of the AV delay appears to be one of the mechanisms by which biventricular pacing delivers its beneficial effect.…”

Section: His Pacing To Deliver Ventricular Resynchronisation In Patiementioning

confidence: 99%

His Bundle Pacing: A New Frontier in the Treatment of Heart Failure

Ali¹,

Keene²,

Arnold³

et al. 2018

Arrhythmia &Amp; Electrophysiology Review

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Biventricular pacing has revolutionised the treatment of heart failure in patients with sinus rhythm and left bundle branch block; however, left ventricular-lead placement is not always technically possible. Furthermore, biventricular pacing does not fully normalise ventricular activation and, therefore, the ventricular resynchronisation is imperfect. Right ventricular pacing for bradycardia may cause or worsen heart failure in some patients by causing dyssynchronous ventricular activation. His bundle pacing activates the ventricles via the native His-Purkinje system, resulting in true physiological pacing, and, therefore, is a promising alternate site for pacing in bradycardia and traditional CRT indications in cases where it can overcome left bundle branch block. Furthermore, it may open up new indications for pacing therapy in heart failure, such as targeting patients with PR prolongation, but a narrow QRS duration. In this article we explore the physiology, technology and potential roles of His bundle pacing in the prevention and treatment of heart failure.

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Hyper-response to cardiac resynchronization with permanent His bundle pacing: Is parahisian pacing sufficient?

Cited by 10 publications

References 14 publications

Permanent His-bundle pacing using stylet-directed, active-fixation leads placed via coronary sinus sheaths compared to conventional lumen-less system

Permanent His-bundle pacing using stylet-directed, active-fixation leads placed via coronary sinus sheaths compared to conventional lumen-less system

(Super-responder to His-bundle pacing - case report)

His Bundle Pacing: A New Frontier in the Treatment of Heart Failure

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