Cardiology Letters 2019, 28(4):151-157

Permanent stimulation of His bundle - initial experiences

Ťažký V¹, Čambál D^{1, 2}, Hojerová S¹, Beňačka J^{1, 3}

¹ Klinika vnútorných chorôb, Fakultná nemocnica Trnava

² Katedra LVM v zdravotníctve, Fakulta zdravotníctva a sociálnej práce, TU Trnava

³ Katedra ošetrovateľstva, Fakulta zdravotníctva a sociálnej práce, TU Trnava, Slovenská republika

Goal of the paper: Permanent cardiac pacing of the right ventricle is an effective therapeutic option for patients with bradycardic rhythm disorders. Pacing of the right ventricle, especially its apex, currently remains the most widely used method due to simple implantation. The unfavourable effect of long-term pacing on hemodynamic condition led to the development of novel implantation methods. His bundle pacing (HBP) is currently the most topical physiologic alternative to permanent pacing. HBP gives a real chance for achieving physiologic cardiac pacing by the prevention of ventricular dyssynchrony.

Methods: Permanent cardiac pacing by stimulating His bundle using the specially developed system.

Results: The first three HBP implantations were successful. In two cases we achieved S-HBP and in one case NS-HBP. The width of paced QRS complex did not change in patients with S-HBP. In the case of NS-HBP prolongation by 20 ms was observed. Pacing stimulation thresholds were fully comparable with the classic pacing. During the index hospitalization we did not observe any complications. All patients had pacemaker check-ups after 6 months. Check-up pacing parameters were unchanged; in one case we noticed sensing decrease.

Conclusion: Permanent pacing of His Bundle (HBP) seems to be the hemodynamically optimal method of therapy for bradycardic rhythm disorders requiring permanent cardiac pacing. This method also has the potential for heart failure therapy; it even seems to be more efficient than biventricular pacing. Implementation of this method into common clinical practice requires systematic training of pacing technique in more cardiac pacing centres.

Keywords: physiologic cardiac pacing; permanent pacing of His bundle

Published: April 1, 2019  Show citation