November 16, 2018Open Access
Programmed His bundle pacing - a novel maneuver for the diagnosis of His bundle capture
Key result
Programmed His bundle pacing correctly diagnosed all non-selective His bundle cases by demonstrating a shorter RV-myocardial ERP compared to His bundle ERP (271.8 vs 353.0 ms, p<0.0001).
Why the study?
During permanent non-selective His bundle pacing, it is crucial to confirm His bundle capture and exclude isolated RV-myocardial septal pacing.
Does programmed His bundle pacing differentiate non-selective His bundle capture from RV-myocardial capture in patients undergoing His bundle pacemaker implantation?
Population
32 consecutive patients during HB pacemaker implantation across 50 different sites
Comparison
Programmed extra-stimulus pacing during intrinsic rhythm vs after a 600 ms drive train
Design
Consecutive cohort study
Authors
Discussion
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Member takes
Implication
May aid differentiation of non-selective His bundle capture; leaves open prospective validation before routine use.
Study Design
Type
Observational (n=32)
Structured PICO
Does programmed His bundle pacing differentiate non-selective His bundle capture from RV-myocardial capture in patients undergoing His bundle pacemaker implantation?
P
Population
32 consecutive patients undergoing His bundle pacemaker implantation
I
Intervention
Programmed His bundle pacing (premature beats introduced at 10 ms steps during intrinsic rhythm and after a drive train of 600 ms)
O
Outcome
Differentiation of non-selective His bundle capture from RV-myocardial capture based on effective refractory period (ERP) differencessurrogate
Main Result
Absolute Event Rate: 271.8% vs 353%
p-value: p=<0.0001
Programmed His bundle pacing is a novel and effective method to differentiate non-selective His bundle capture from RV-myocardial capture by exploiting differences in effective refractory periods.
Cite This Study
Jastrzębski et al. (2018) conducted an observational in His bundle pacemaker implantation (n=32). Programmed His bundle pacing was evaluated on Effective refractory period (ERP) of RV-myocardium vs His bundle (p=<0.0001). Programmed His bundle pacing correctly diagnosed all non-selective His bundle cases by demonstrating a shorter RV-myocardial ERP compared to His bundle ERP (271.8 vs 353.0 ms, p<0.0001).