Key result
Selective His bundle pacing guided by a 3D mapping system increased lead threshold and decreased sensing compared to nonselective pacing.
Why the study?
Permanent His bundle pacing presents structural cardiac challenges, prompting investigation into the feasibility and efficacy of guidance using a three-dimensional mapping system.
Does permanent His bundle pacing guided by a 3D mapping system improve procedural outcomes in patients requiring cardiac pacing?
Observational (n=30)
Does permanent His bundle pacing guided by a 3D mapping system improve procedural outcomes in patients requiring cardiac pacing?
Permanent His bundle pacing guided by a 3D mapping system is clinically feasible, can decrease X-ray exposure time, and achieves acceptable lead parameters.
Answers are grounded in this paper and cite their sources.
Selective pacing was associated with inferior parameters; hypothesis-generating for 3D-guided His bundle pacing strategies.
Background: Permanent His bundle pacing (HBP) is a promising therapy in cardiac pacing field with high challenge of the heart structure. Cardiac mapping system provides us a comprehensive model of heart structure. The study aimed to investigate the feasibility and efficacy of HBP guided by three-dimensional (3D) mapping system. Subjects and Methods: Thirty patients undergoing permanent HBP through 3D mapping system were enrolled in this observational study between January 2016 and May 2018. The study was approved by the Ethics Review Committee of Fuwai Central China Cardiovascular Hospital. The average age of the study population was 59.2 years old, with 17 male patients. Factors including the whole operation time, the X-ray exposure time, the lead parameters, and QRS duration before and after the surgery were analyzed. Results: The study population was divided into two groups: 20 patients in selective HBP group (only capture His bundle) and 10 patients in nonselective HBP group (capture both His bundle and Para-Hisian ventricular tissue). The average whole operation time of HBP guided by 3D mapping system was 113 minutes, and there is no significant difference in the X-ray exposure time between selective HBP and nonselective HBP (P > 0.05). Four patients received HBP with zero fluoroscopy. The intraprocedural lead parameters threshold was significantly increased (1.80 ± 0.50 V vs. 1.21 ± 0.41 V) while sensing was significantly decreased (3.30 ± 0.63 mV vs. 7.40 ± 0.99 mV) in the selective HBP group compared with in the nonselective HBP group (P < 0.05 and P < 0.01). Conclusion: The permanent HBP guided by 3D mapping system was feasible clinically in decreasing X-ray exposure time and achieving perfect lead parameters.
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Zhao et al. (2019) conducted an observational in Patients requiring permanent cardiac pacing (n=30). Selective His bundle pacing vs. Nonselective His bundle pacing was evaluated on Intraprocedural lead parameters (threshold and sensing) (p=<0.05). Selective His bundle pacing guided by a 3D mapping system increased lead threshold and decreased sensing compared to nonselective pacing.
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