Key result
His bundle pacing reverses LV dysfunction and improves exercise tolerance in two congenital AV block patients.
Why the study?
Most patients with congenital complete atrioventricular block require pacemaker therapy but face detrimental effects from chronic RV pacing, making conduction system pacing an alternative to restore electromechanical coupling.
Does His bundle pacing improve exercise tolerance and echocardiographic parameters in patients with complete congenital atrioventricular block?
Case Report (n=2)
Does His bundle pacing improve exercise tolerance and echocardiographic parameters in patients with complete congenital atrioventricular block?
His bundle pacing may restore normal activation pathways and improve left ventricular dysfunction and exercise tolerance in patients with congenital complete AV block.
His bundle pacing may aid select congenital AV block cases; hypothesis-generating and leaves open need for prospective trials.
Congenital complete atrioventricular block (CCAVB) is usually due to failure of atrioventricular nodal conduction with preservation of the His‐Purkinje system. Most patients with CCAVB ultimately require pacemaker therapy to restore physiologic heart rates, dealing with the detrimental effects of chronic right ventricular (RV) pacing on cardiac structure and function. The ideal stimulation pattern aims to mimic the normal conduction to restore electromechanical coupling, preventing the harmful effects of lack of atrioventricular and inter‐intraventricular synchrony. This can be done through conduction system pacing. Using His bundle pacing (HBP) for cardiac resynchronization therapy in two complete congenital atrioventricular block patients, we have reported better exercise tolerance and echocardiographic improvements related to reversible left ventricular dysfunction that can be corrected by restoration of the normal activation pathway via the His‐Purkinje network.
No takes yet. Share an insight, caveat, or question.
Piemontese et al. (2022) conducted a case report in Congenital complete atrioventricular block (CCAVB) (n=2). His bundle pacing (HBP) was evaluated on Exercise tolerance and echocardiographic improvements. His bundle pacing for cardiac resynchronization therapy in two patients with congenital complete AV block improved exercise tolerance and reversed left ventricular dysfunction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: