Permanent His Bundle Pacing Implantation Facilitated by Visualization of the Tricuspid Valve Annulus.
Circ Arrhythm Electrophysiol
; 13(10): e008370, 2020 10.
Article
em En
| MEDLINE
| ID: mdl-32911981
ABSTRACT
BACKGROUND:
His bundle pacing (HBP) is the most physiological pacing modality. However, HBP has longer procedure times with frequent high capture thresholds, which likely contributes to the low adoption of this approach. The aim of this study is to compare HBP implantation with a novel imaging technique versus the standard implantation technique.METHODS:
This study included 50 patients with standard pacing indications randomized to HBP with visualization of the tricuspid valve annulus (N=25, the visualization group) or with the standard method (N=25, the control group). In the visualization group, the tricuspid valve annulus was imaged by contrast injection in the right ventricle during fluoroscopy. The site for HBP was identified in relationship to the tricuspid septal leaflet and interventricular septum.RESULTS:
Permanent HBP was successful in 92% in the visualization group and 88% in the control group. The fluoroscopic time for HBP lead placement was significantly shorter in the visualization group (7.1±3.3 minutes) compared with the control group (10.1±5.6 minutes, P=0.03). Total procedural and fluoroscopic times were also significantly shorter in the visualization group (91.0±15.7 and 9.6±3.8 minutes) than the control group (104.4±17.8 and 12.7±6.2 minutes, P=0.01 and 0.04, respectively). There was no significant difference in capture threshold between groups. In the visualization group, there was a quantitative association between the HBP site and the tricuspid valve annulus.CONCLUSIONS:
The visualization technique shortens the procedural and fluoroscopic times for HBP implantation. Moreover, anatomic localization of HBP sites is strongly associated with physiological characteristics of pacing, which can help guide optimal lead placement. Registration URL https//www.chictr.org.cn/index.aspx. Unique identifier ChiCTR2000029834.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Arritmias Cardíacas
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Valva Tricúspide
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Fascículo Atrioventricular
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Estimulação Cardíaca Artificial
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Radiografia Intervencionista
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Pontos de Referência Anatômicos
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article