His-Bundle pacing significantly improved right ventricular fractional area change (median 37% vs 30%, p<0.0001) and global longitudinal strain compared to right ventricular pacing at 6 months.
Observational (n=84)
Does His-Bundle pacing improve right ventricular performance compared to apical right ventricular pacing in patients undergoing permanent pacemaker implantation?
His-bundle pacing preserves and improves right ventricular echocardiographic performance at 6 months compared to apical right ventricular pacing, which causes deterioration.
Absolute Event Rate: 37% vs 30%
p-value: p=<0.0001
BACKGROUND: His-Bundle pacing (HBP) is an emerging technique for physiological pacing. However, its effects on right ventricle (RV) performance are still unknown. METHODS: We enrolled consecutive patients with an indication for pacemaker (PM) implantation to compare HBP versus RV pacing (RVP) effects on RV performance. Patients were evaluated before implantation and after 6 months by a transthoracic echocardiogram. RESULTS: A total of 84 patients (age 75.1±7.9 years, 64% male) were enrolled, 42 patients (50%) underwent successful HBP, and 42 patients (50%) apical RVP. At follow up, we found a significant improvement in RV-FAC (Fractional Area Change)% baseline: HBP 34 IQR (31-37) vs. RVP 33 IQR (29.7-37.2),p = .602; 6-months: HBP 37 IQR (33-39) vs. RVP 30 IQR (27.7-35), p < .0001 and RV-GLS (Global Longitudinal Strain)% baseline: HBP -18 IQR (-20.2 to -15) vs. RVP -16 IQR (-18.7 to -14), p = .150; 6-months: HBP -20 IQR(-23 to -17) vs. RVP -13.5 IQR (-16 to -11), p < .0001 with HBP whereas RVP was associated with a significant decline in both parameters. RVP was also associated with a significant worsening of tricuspid annular plane systolic excursion (TAPSE) (p < .0001) and S wave velocity (p < .0001) at follow up. Conversely from RVP, HBP significantly improved pulmonary artery systolic pressure (PASP) baseline: HBP 38 IQR (32-42) mmHg vs. RVP 34 IQR (31.5-37) mmHg,p = .060; 6-months: HBP 32 IQR (26-38) mmHg vs. RVP 39 IQR (36-41) mmHg, p < .0001 and tricuspid regurgitation (p = .005) irrespectively from lead position above or below the tricuspid valve. CONCLUSIONS: In patients undergoing PM implantation, HBP ensues a beneficial and protective impact on RV performance compared with RVP.
Grieco et al. (Fri,) conducted a observational in Indication for pacemaker implantation (n=84). His-Bundle pacing (HBP) vs. Apical right ventricle pacing (RVP) was evaluated on Right ventricular performance (RV-FAC %) (p=<0.0001). His-Bundle pacing significantly improved right ventricular fractional area change (median 37% vs 30%, p<0.0001) and global longitudinal strain compared to right ventricular pacing at 6 months.