Validation of criteria for selective his bundle and para-hisian permanent pacing.
Pacing Clin Electrophysiol
; 29(12): 1326-33, 2006 Dec.
Article
en En
| MEDLINE
| ID: mdl-17201838
BACKGROUND: His Bundle (HB) pacing is a valid alternative to right ventricular pacing for patients with preserved His-ventricle conduction who are candidates for permanent stimulation. Permanent pacing in the HB area enables Selective HB pacing (SHBP) or para-Hisian pacing (PHP) to be achieved. The aim of our study was to draw up a set of easy criteria to differentiate and validate the two kinds of stimulations according to the pacing output and the ECG/EKG signals. METHODS AND RESULTS: From February to July 2005, 17 patients eligible for a pacemaker (PM) procedure underwent implantation with the Medtronic SelectSecure lead (Medtronic, Minneapolis, MN, USA) screwed into the HB area.SHBP was defined when the intrinsic QRS was equal, in both duration and morphology, to the paced QRS, the His-Ventricular (H-V) interval was equal to Pace-Ventricular interval (Vp-V) and, at low output, only the HB was captured, while increasing the output resulted in both the HB and right ventricular (RV) being captured (widening of QRS at high output). Conversely, PHP was defined when the intrinsic QRS differed from the paced one, either in morphology or in duration and, at high output, both the RV and HB were captured (non-SHBP), while decreasing the output resulted in losing HB capture (widening of QRS at low output). According to these criteria, SHBP was achieved in 11 patients, while in the remaining 6, PHP was obtained. No adverse events were reported. CONCLUSIONS: The above criteria enabled SHBP and PHP to be validated easily and clearly. A longer follow-up will be needed in order to ascertain whether the clinical outcome of these two approaches differs.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Arritmias Cardíacas
/
Fascículo Atrioventricular
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Estimulación Cardíaca Artificial
/
Selección de Paciente
/
Electrocardiografía
Tipo de estudio:
Clinical_trials
Límite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Año:
2006
Tipo del documento:
Article
País de afiliación:
Italia
Pais de publicación:
Estados Unidos