Step-wise Approach to Permanent His Bundle Pacing
نویسنده
چکیده
There has been a recent upsurge of interest in permanent His bundle pacing, given increased understanding and appreciation of the role dyssynchronous ventricular activation plays in congestive heart failure and atrial fibrillation. Permanent His bundle pacing gives implanters the ability to avoid causing ventricular dyssynchrony in patients dependent on ventricular pacing, and can provide an alternative means to implementing cardiac resynchronization therapy in patients with bundle branch disease and congestive heart failure. This paper describes a step-wise approach to implanting permanent His bundle pacing leads, with a clear demonstration of techniques and observations encountered during the course of typical His bundle lead implantations, including consideration of potential pitfalls and workarounds.
منابع مشابه
Acute His Bundle Injury during Permanent His Bundle Pacing: Mechanistic Insights into Intra- Hisian Block
Permanent His bundle pacing (HBP) is a physiological alternative to right ventricular pacing. Acute injury to the His bundle can occur during permanent HBP in the form of transient or permanent bundle branch blocks. Observations of mechanical injury to the His bundle during HBP lead fixation and electrophysiological response to HBP provides additional mechanistic insights into the pathology of ...
متن کاملThe potential and reality of permanent his bundle pacing.
Right ventricular apex pacing can have deleterious effects. Our aims were to investigate how many patients referred for permanent pacing were suitable candidates for permanent His bundle pacing, and to determine the proportion in whom such pacing was successful. All cases of suprahisian block and most cases of infrahisian block (71.4%) were corrected by temporary His bundle pacing. However, per...
متن کاملHyper-response to cardiac resynchronization with permanent His bundle pacing: Is parahisian pacing sufficient?
The feasibility of resynchronizing ventricular activation by permanent pacing of the His bundle region has been previously described, and has clinical advantages over traditional right ventricular (RV) apical pacing.1–4 The physiologic benefit of permanent His bundle pacing (HBP) is the ability to stimulate the ventricles through the intrinsic His-Purkinje system, which results in synchronous e...
متن کاملPermanent His bundle pacing at the time of atrioventricular node ablation: A 3-dimensional mapping approach
Introduction Cardiac resynchronization therapy (CRT) has shown a significant clinical benefit over right ventricular pacing in patients with left ventricular dysfunction and a high ventricular pacing requirement. Traditionally, CRT has relied on coronary sinus (CS) lead placement through the use of fluoroscopy and venography. Three-dimensional (3D) electroanatomic mapping has been used as an al...
متن کاملOvercoming left bundle branch block by permanent His bundle pacing: Evidence of longitudinal dissociation in the His via recordings from a permanent pacing lead
Introduction Narrowing of the QRS and overcoming left bundle branch block (LBBB) with His bundle pacing (HBP) has been previously described. We present the first 2 reported cases of left bundle branch (LBB) delay with evidence of a split His electrogram during unipolar mapping from the tip of the His bundle (HB) lead during pacemaker implantation. These findings suggest that the site of LBB del...
متن کامل