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HIS BUNDLE PACING AS AN ALTERNATIVE TO CARDIAC RESYNCHRONIZATION: A SINGLE CENTER EXPERIENCE
Session:
Sessão de Comunicações Orais - Dispositivos Médicos
Speaker:
José Alencar
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.3 Cardiac Resynchronization Therapy
Session Type:
Comunicações Orais
FP Number:
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Authors:
José Alencar; Fabio Klemz; Francisco Moscoso Costa; Gustavo Da Rocha Rodrigues; João Carmo; Daniel Nascimento Matos; Flávio Mendonça; Pedro Lopes Do Carmo; Francisco Bello Morgado; Diogo Cavaco; Pedro Adragão
Abstract
<p>INTRODUCTION</p> <p> </p> <p>Permanent His bundle pacing (HBP) is an emerging alternative to right ventricular apex pacing. It has the potential to restore physiological activation of the ventricles and achieve synchrony (1). This technique might also be useful as an alternative to biventricular pacing (2). </p> <p> </p> <p>METHODS</p> <p> </p> <p>We aim to assess electrocardiographic and clinical outcomes of the patients of a tertiary cardiologic center in Portugal submitted to permanent HBP as an alternative to biventricular pacing to achieve cardiac resynchronization therapy (CRT) in years 2018 and 2019.</p> <p> </p> <p>RESULTS</p> <p> </p> <p>Permanent HBP in order to achieve cardiac resynchronization was performed in 17 (11 CRT-D, 4 CRT-P and 2 double-chamber ICD with His electrode connected to atrial channel). patients from March 2018 to December 2019. Mean age was 77 years (48 – 90) and 41% were female. 35% had a complete left bundle branch block (LBBB), 23% had right apex ventricle pacing, 11% had narrow QRS (with programmed future AV nodal ablation) and 5% had right bundle branch block (RBBB) pattern previous to implant. Immediate post-implant QRS measure demonstrated significant narrowing from a median of 184 ms to 155 ms (p: 0.02, Wilcoxon signed-rank test). 11 of the 17 patients had a 6 months follow-up, and an improvement in New York Heart Association (NYHA) functional class was noticed: 2.54 to 1.81 (p: 0.02, Pearson correlation test). Only one of these 11 patients on follow-up (9%) worsen NYHA functional class (anemia under investigation). Pocket-related complications occurred in 1 patient – hematoma.</p> <p> </p> <p>CONCLUSION</p> <p> </p> <p>In this single center report, permanent HBP as an alternative to cardiac resynchronization significantly reduced QRS length and improved NYHA functional class without significant complications. </p>
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