A single-centre experience of His bundle pacing without electrophysiological mapping system: implant success rate, safety, pacing characteristics and one-year follow up.

Content Provider	Europe PMC
Author	Kui, Swee Leng Yeo, Colin Teo, Lisa Him, Ai Ling Syed Hamid, Sherida Binte Wong, Kelvin Tan, Vern Hsen
Copyright Year	2023
Abstract	Introduction: Despite the challenges related to His bundle pacing (HBP), recent data suggest an improved success rate with experience. As a non-university, non-electrophysiology specialised centre in Singapore, we report our experiences in HBP using pacing system analyser alone. Methods: Data of 28 consecutive patients who underwent HBP from August 2018 to February 2019 was retrospectively obtained. The clinical and technical outcomes of these patients were compared between two timeframes of three months each. Patients were followed up for 12 months. Results: Immediate technical success was achieved in 21 (75.0%) patients (mean age 73.3 ± 10.7 years, 47.6% female). The mean left ventricular ejection fraction was 53.9% ± 12.1%. The indications for HBP were atrioventricular block (n = 13, 61.9%), sinus node dysfunction (n = 7, 33.3%) and upgrade from implantable cardioverter-defibrillator to His-cardiac resynchronisation therapy (n = 1, 4.8%). No significant difference was observed in baseline characteristics between Timeframe 1 and Timeframe 2. Improvements pertaining to mean fluoroscopy time were achieved between the two timeframes. There was one HBP-related complication of lead displacement during Timeframe 1. All patients with successful HBP achieved non-selective His bundle (NSHB) capture, whereas only eight patients had selective His bundle (SHB) capture. NSHB and SHB capture thresholds remained stable at the 12-month follow-up. Conclusion: Permanent HBP is feasible and safe, even without the use of an electrophysiology recording system. This was successfully achieved in 75% of patients, with no adverse clinical outcomes during the follow-up period.
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ISSN	00375675
Volume Number	64
DOI	10.11622/smedj.2022066
PubMed Central reference number	PMC10335630
Issue Number	6
PubMed reference number	35651294
Journal	Singapore Medical Journal [Singapore Med J]
e-ISSN	27375935
Language	English
Publisher	Wolters Kluwer - Medknow
Publisher Date	2023-06-01
Publisher Place	India
Access Restriction	Open
Rights License	This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Copyright: © 2023 Singapore Medical Journal
Subject Keyword	Feasibility His bundle learning curve pacing
Content Type	Text
Resource Type	Article
Subject	Medicine