PO-01-182 CONDUCTION SYSTEM PACING REMAINS EFFECTIVE IN PATIENTS WITH NON-CONDUCTIVE SEPTAL SCAR BUT SURVIVING PURKINJE

Conduction system pacing (CSP), delivered through His bundle (HBP) or left (LBP), is a novel effective treatment for patients with proximal branch block (LBBB). The presence of septal scar known to affect response CSP, but the effect conduction properties on CSP has never been investigated. To quantify scarred myocardium and Purkinje velocity (CV) using computational modelling. We computed ventricular activation 24 four-chamber heart geometries generated from failure patients, inclusive His-Purkinje networks LBBB. simulated LBBB baseline, selective HBP LBP optimized atrioventricular delay (AVD) following within scar: A) non-conductive Purkinje; B) slow conductive (10% CV compared healthy tissue); C) Purkinje. Response was quantified 90% biventricular (BIVAT90) 95% (LV) times. were ineffective in (LVAT95: baseline 130.9±11.2ms vs 129.4±13.9ms LBP: 130.2±11.6, P=0.9, Fig A,D). reduced BIVAT90 LVAT95 when (BIVAT90: 120.7±9.5ms, HBP: 98.1±11.2ms, 82.9±9.4ms, P<0.01 B,D). remained 115.7±11.2ms, 84.4±7.6ms, 64.3±8.6ms, C,D). does not necessarily make ineffective. remains if still conductive.