Direct His bundle pacing produced a dramatic clinical response in a young woman with congenital complete AV block and right ventricular pacing-induced cardiomyopathy.
Case Report (n=1)
Does direct His bundle pacing improve clinical outcomes in a patient with congenital complete AV block and RV pacing-induced cardiomyopathy?
Direct His bundle pacing may be an effective strategy to reverse RV pacing-induced cardiomyopathy in patients with congenital complete AV block.
Congenital complete atrioventricular block (CCAVB) is usually due to failure of AV nodal conduction with preservation of the His Purkinje system, typically present at birth. While most patients with CCAVB ultimately require pacemaker therapy to restore physiologic heart rates, recent studies have suggested that chronic right ventricular (RV) pacing in patients with CCAVB can have detrimental effects on cardiac structure and function, and may account for a 7-10% incidence of congestive heart failure in these patients. Since the His Purkinje system is preserved in CCAVB, this patient population could be uniquely well served by direct His bundle pacing (DHBP) which would be expected to restore physiologic activation of both ventricles. We present a case of a young woman who presented with RV pacing-induced cardiomyopathy who responded dramatically to DHBP.
REHWINKEL et al. (Mon,) conducted a case report in Congenital complete atrioventricular block and RV pacing-induced cardiomyopathy (n=1). Direct His bundle pacing (DHBP) vs. Right ventricular pacing was evaluated on Clinical response. Direct His bundle pacing produced a dramatic clinical response in a young woman with congenital complete AV block and right ventricular pacing-induced cardiomyopathy.