| Electrical resynchronization induced by direct His-bundle pacing. | |
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MedLine Citation:
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PMID: 19914142 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Biventricular pacing (BiV) to effect cardiac resynchronization therapy can be technically difficult and fails to elicit a clinical response in 30% to 40% of patients. Direct His-bundle pacing (DHBP) theoretically could obviate some of these problems. Although DHBP is capable of narrowing the QRS in some patients, the consistency with which this can be achieved has not been characterized. OBJECTIVE: The purpose of this study was to restore His-Purkinje functionality in consecutive patients undergoing de novo clinically mandated cardiac resynchronization therapy. METHODS: DHBP was temporarily implemented at the time of implantation of a permanent BiV system in patients referred for cardiac resynchronization therapy. Native conduction, DHBP, and BiV QRS duration were compared. All patients presenting for BiV cardiac resynchronization therapy were eligible for the study. Ten patients were studied. RESULTS: DHBP was successfully implemented in all 10 patients. In 7 of 10 patients, DHBP narrowed the QRS significantly compared with native conduction and BiV (mean QRS duration: native 171 +/- 13 ms, DHBP 148 +/- 11 ms, BiV 158 +/- 21, P <.0001). QRS narrowing with DHBP was specifically attributable to capture of latent His-Purkinje tissue. DHBP lead implantation time (16 minutes) was shorter than standard left ventricular lead implantation time (42 minutes). CONCLUSION: DHBP was readily implemented in patients with standard indications for BiV cardiac resynchronization therapy. In most patients studied, DHBP resulted in a significantly narrower QRS compared with native conduction. DHBP may offer a physiologic alternative to BiV for cardiac resynchronization therapy. |
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Authors:
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Daniel L Lustgarten; Susan Calame; Eric M Crespo; James Calame; Robert Lobel; Peter S Spector |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-10-06 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 7 ISSN: 1556-3871 ISO Abbreviation: Heart Rhythm Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-02-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 15-21 Citation Subset: IM |
Affiliation:
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Cardiovascular Research Institute, Burlington, Vermont, USA. daniel.lustgarten@vtmednet.org. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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