Key result
Permanent His-bundle pacing maintains ventricular synchrony over RVP by engaging the intrinsic His-Purkinje system.
Why the study?
Does permanent His-bundle pacing maintain ventricular synchrony and prevent pacing-mediated cardiomyopathy compared to conventional right ventricular pacing in patients requiring pacemakers?
Does permanent His-bundle pacing maintain ventricular synchrony and prevent pacing-mediated cardiomyopathy compared to conventional right ventricular pacing in patients requiring pacemakers?
His-bundle pacing is highlighted as an important alternative to conventional RV pacing to maintain ventricular synchrony and prevent pacing-induced cardiomyopathy.
May support His-bundle pacing to avoid dyssynchrony; leaves open need for randomized confirmation before practice change.
Permanent pacemaker implant is a commonly performed cardiac procedure for treatment of bradycardia or conduction system abnormality. With conventional right ventricular (RV) pacing a lead is implanted at the RV apex or on the RV septum. However, RV apical or RV septal pacing causes iatrogenic left bundle-branch block and ventricular dyssynchrony and can lead to adverse cardiac remodeling, a pacing-mediated cardiomyopathy, and congestive heart failure. Alternatively, permanent His-bundle pacing uses the intrinsic rapidly-conducting His-Purkinje system to activate the ventricle, thereby maintaining (or sometimes even restoring) ventricular synchrony. Many patients may derive benefit from permanent His-bundle pacing.
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Kaufmann et al. (2018) conducted a review in Bradycardia or conduction system abnormality. His-bundle pacing vs. Conventional right ventricular (RV) pacing was evaluated. Permanent His-bundle pacing uses the intrinsic His-Purkinje system to activate the ventricle, maintaining or restoring ventricular synchrony compared to conventional right ventricular pacing.
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