Key result
Surface ECG alone can falsely indicate successful HBP capture, necessitating concurrent pacing parameter analysis.
Why the study?
His-bundle pacing is associated with higher risks of lead dislodgement, undersensing, and loss of capture, making detailed assessment of pacing effectiveness vital.
Case Report (n=1)
Patients receiving His-bundle pacing should undergo pacing parameter analysis and pacing electrograms alongside ECG, as differences between successful and unsuccessful pacing can be subtle.
His-bundle pacing (HBP) is a relatively new method of cardiac pacing, with recent studies showing an association between HBP and a lower risk of developing right ventricular heart failure compared to classical pacing methods. However, HBP is also associated with a higher risk of lead dislodgement, undersensing, and loss of capture. As such, a detailed assessment of pacing effectiveness in pacemaker patients is vital. In the presented case, an electrocardiogram (ECG) recording seems to present successful selective His-bundle pacing, while pacemaker follow-up demonstrated the loss of ventricular capture. In conclusion, patients receiving HBP should undergo ECG alongside pacing parameter analysis and pacing electrograms, as differences in successful and unsuccessful pacing ECG can be very subtle.
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Świerżyńska et al. (2023) conducted a case report in His-bundle pacing (n=1). His-bundle pacing was evaluated. His-bundle pacing assessment using only surface ECG can falsely indicate successful capture despite actual loss of ventricular capture, necessitating concurrent pacing parameter analysis.
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