Key result
Permanent His-bundle pacing may be a preferred option in pediatric and congenital heart disease populations to restore physiologic electric conduction and improve ventricular function.
Why the study?
His-bundle pacing improves ventricular function in adults, but its role and deployment in pediatric and congenital heart disease populations require synthesis of current evidence.
Permanent His-bundle pacing is a promising alternative to traditional biventricular pacing for restoring physiologic ventricular activation in pediatric and congenital heart disease patients, though further studies are needed to assess long-term outcomes.
May warrant consideration for physiologic pacing in select pediatric cases; leaves open need for prospective trials on durability and selection.
Permanent His-bundle pacing has been gaining popularity in the adult population requiring cardiac resynchronization therapy. Initial procedural challenges are being overcome, and this method of pacing has been shown to improve left ventricular function and heart failure symptoms secondary to ventricular dyssynchrony. Though the etiologies of ventricular dyssynchrony may differ in children and those with congenital heart disease than in adults with structurally normal hearts, His-bundle pacing may also be a preferred option in these groups to restore more physiologic electric conduction and improve ventricular function. We present a review of the current literature and suggested directions involving deploying permanent His-bundle pacing in the pediatric and congenital heart disease population.
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Lyon et al. (2020) conducted a review in Congenital heart disease and pediatric arrhythmias requiring pacing. Permanent His-bundle pacing vs. Right ventricular or biventricular pacing was evaluated. Permanent His-bundle pacing may be a preferred option in pediatric and congenital heart disease populations to restore physiologic electric conduction and improve ventricular function.
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