Key result
Upgrading to distal His bundle pacing improved left ventricular ejection fraction from 40% to 60% in a young girl with pacing-induced ventricular dysfunction.
Why the study?
The effects and relevance of His bundle pacing in pediatric patients are largely unresolved, with only limited data analyzing its feasibility and efficacy in this population.
Does distal His bundle pacing improve LV ejection fraction in a pediatric patient with pacing-induced ventricular dysfunction?
Case Report (n=1)
Does distal His bundle pacing improve LV ejection fraction in a pediatric patient with pacing-induced ventricular dysfunction?
Distal His bundle pacing may promote reverse remodeling and restore normal ventricular function in pediatric patients with pacing-induced ventricular dysfunction.
May support distal His bundle pacing in pediatric pacing-induced dysfunction; hypothesis-generating and should not yet change practice.
Children with indications of pacing often require epicardial pacemakers with generators implanted in the abdominal wall due to small body size or challenging anatomy because of congenital heart diseases. However, left ventricle (LV) systolic dyssynchrony induced by epicardial pacing may result in adverse remodeling and LV dysfunction. Recently, distal His bundle pacing (dHBP) has been shown to restore normal ventricular function in adult patients with pacemaker induced ventricular dysfunction. Nevertheless, the effects and relevance of HBP in pediatric patients are largely unresolved, with only limited data analyzing the feasibility and efficacy of HBP in the pediatric population. We report the case of a young girl with congenital atrioventricular (AV) block who developed LV dysfunction induced by prolonged epicardial stimulation. After upgrading to dHBP, she improved her LV ejection fraction from 40% to 60% and maintained stable pacing-sensing parameters over-time. We here provide a review of existing literature on the topic.
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Giaccardi et al. (2024) conducted a case report in Congenital atrioventricular (AV) block with pacing-induced left ventricular dysfunction (n=1). Distal His bundle pacing (dHBP) vs. Prolonged epicardial stimulation (baseline) was evaluated on Left ventricular ejection fraction. Upgrading to distal His bundle pacing improved left ventricular ejection fraction from 40% to 60% in a young girl with pacing-induced ventricular dysfunction.
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