期刊
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
卷 38, 期 5, 页码 540-546出版社
WILEY
DOI: 10.1111/pace.12571
关键词
His-bundle pacing; pacing; heart failure
IntroductionHis-bundle (HB) pacing (P) is a physiological alternative to right ventricular pacing (RVP), but is technically challenging and limited by higher pacing thresholds. Myocardial injury current (IC) recorded during right ventricular lead placement implies good tissue contact and is associated with low-pacing thresholds. IC at the HB has not been previously described. We hypothesized that HBIC during permanent HBP may be associated with lower pacing thresholds. MethodsPermanent HBP was performed using Medtronic Select Secure(tm) (Medtronic Inc., Minneapolis, MN, USA) delivered via a fixed-curve (C315 His) sheath. HB electrogram (EGM) was recorded in a unipolar fashion from the lead tip. Presence or absence of HBIC was documented. HBP threshold, sensing, and impedances were recorded at implant, 2 weeks, 2 months, and 1 year. ResultsSixty patients (age 72 15 years; male 55%, sick sinus syndrome 40%, atrioventricular block 60%, fluoroscopy duration 9.2 +/- 3.7 minutes) underwent successful permanent HBP. HBIC was recorded in 22 (37%) patients (group I). HBEGM without IC was recorded in the remaining 38 (63%) patients (group II). Pacing threshold at implant, 2 weeks, 2 months, and 1 year were significantly lower in group I (1.16 +/- 0.4 V; 1.18 +/- 0.5 V; 1.23 +/- 0.6 V; 1.3 +/- 0.6 V @ 0.5 ms) compared to group II (1.75 +/- 0.7 V; 1.82 +/- 0.8 V; 1.93 +/- 0.8 V; 1.98 +/- 0.9 V @ 0.5 ms, P < 0.05), respectively. ConclusionsIC can be recorded at the HB during permanent HBP in 37% of patients. HBIC is associated with significantly lower pacing thresholds compared to patients in whom HBIC was not recorded. HBIC may be a marker for superior short-term HBP thresholds.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据