This case report describes the implantation of a dual-chamber ICD utilizing His bundle pacing and a right ventricular lead, which was followed months later by decompensated right-sided heart failure.
May indicate right-sided HF risk after His-RV ICD; leaves open long-term safety of this pacing strategy.
An 81-year-old man was admitted in our department for a decompensated ischaemic cardiomyopathy and permanent bradyarrhythmia with narrow QRS complexes. Transthoracic echocardiography showed decreased left ventricular ejection fraction (34%) with mild mitral and moderate tricuspid regurgitation (TR). A dual-chamber implantable cardioverter-defibrillator was implanted with a right ventricular (RV) lead connected to the DF-4 port and a His bundle pacing lead to the atrial port. Final programming was in DDD-R mode with selective His bundle pacing through the ‘atrial channel’ for physiological pacing and backup RV pacing within the ventricular safety pacing window through the ventricular channel, as previously described. Months later, the patient was hospitalized for decompensated right-sided...
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Bisson et al. (2020) studied this question.
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