Intermediate-term performance and safety of His-bundle pacing leads: A single-center experience.

Autor:	Teigeler T; Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia., Kolominsky J; Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia., Vo C; Department of Cardiology, Virginia Commonwealth University, Richmond, Virginia., Shepard RK; Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia., Kalahasty G; Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia., Kron J; Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia., Huizar JF; Division of Cardiac Electrophysiology, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia., Kaszala K; Division of Cardiac Electrophysiology, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia., Tan AY; Division of Cardiac Electrophysiology, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia., Koneru JN; Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia., Ellenbogen KA; Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia., Padala SK; Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia. Electronic address: santoshpadala@gmail.com.
Jazyk:	angličtina
Zdroj:	Heart rhythm [Heart Rhythm] 2021 May; Vol. 18 (5), pp. 743-749. Date of Electronic Publication: 2021 Jan 05.
DOI:	10.1016/j.hrthm.2020.12.031
Abstrakt:	Background: The short-term safety, feasibility, and performance of His-bundle pacing (HBP) leads have been reported; however, their longer-term performance beyond 1 year remains unclear. Objective: The purpose of this study was to examine the intermediate-term performance and safety of HBP. Methods: All HBP lead implants at Virginia Commonwealth University between January 2014 and January 2019 were analyzed. HBP was performed using a Medtronic SelectSecure 3830-69 cm pacing lead. Results: Of 295 attempts, successful HBP implantation (selective or nonselective) was seen in 274 cases (93%). Mean follow-up duration was 22.8 ± 19.5 months (median 19.5; interquartile range 11-33). Mean age was 69 ± 15 years; 58% were males; and ejection fraction <50% was noted in 30%. Indications for pacemaker included sick sinus syndrome in 41%, atrioventricular block in 36%, cardiac resynchronization therapy in 7%, and refractory atrial fibrillation in 15%. Selective HBP was achieved in 33%. Mean HBP capture threshold at implant was 1.1 ± 0.9 V at 0.8 ± 0.2 ms, which significantly increased at chronic follow-up to 1.7 ± 1.1 V at 0.8 ± 0.3 ms (P <.001). Threshold was ≥2.5 V in 24% of patients, and 28% had an increase in HBP threshold ≥1 V. Loss of His-bundle capture at follow-up (septal right ventricular pacing) was seen in 17%. There was a total of 31 (11%) lead revisions, primarily for unacceptably high thresholds. Conclusion: Although HBP can prevent or improve pacing-induced cardiomyopathy, the elevated capture thresholds, loss of His-bundle capture, and lead revision rates at intermediate follow-up are of concern. Longer-term follow-up data from multiple centers are needed. (Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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