Cardiac resynchronization therapy in non-ischemic cardiomyopathy: a comparative non-randomized study of His Bundle pacing versus biventricular pacing.

Autor: Moriña-Vázquez P; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramon Jimenez (HJRJ)), Ronda Exterior Norte s/n. 21005, Huelva, Spain., Moraleda-Salas MT; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramon Jimenez (HJRJ)), Ronda Exterior Norte s/n. 21005, Huelva, Spain. teresamoraleda@hotmail.com., Rodríguez-Albarrán A; Department of Cardiology, HJRJ, Huelva, Spain., Arce-León Á; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramon Jimenez (HJRJ)), Ronda Exterior Norte s/n. 21005, Huelva, Spain., Venegas-Gamero J; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramon Jimenez (HJRJ)), Ronda Exterior Norte s/n. 21005, Huelva, Spain., Fernández-Gómez JM; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramon Jimenez (HJRJ)), Ronda Exterior Norte s/n. 21005, Huelva, Spain., Esteve-Ruiz I; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramon Jimenez (HJRJ)), Ronda Exterior Norte s/n. 21005, Huelva, Spain., Barba-Pichardo R; Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramon Jimenez (HJRJ)), Ronda Exterior Norte s/n. 21005, Huelva, Spain.
Jazyk: angličtina
Zdroj: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2023 Aug; Vol. 66 (5), pp. 1077-1084. Date of Electronic Publication: 2022 Mar 29.
DOI: 10.1007/s10840-022-01192-2
Abstrakt: Background: Cardiac resynchronization therapy (CRT) via permanent His bundle pacing (pHBP) has gained acceptance globally, but robust studies comparing pHBP-CRT with classic CRT are lacking. In this study, we aimed to compare the improvement in left ventricular ejection fraction (LVEF) after pHBP-CRT versus classic CRT.
Methods: This was a single-center study comparing a prospective series of pHBP-CRT with a historical series of CRT via classic biventricular pacing (BVP). Patients with non-ischemic cardiomyopathy, baseline LVEF < 35%, left bundle branch block (LBBB), and CRT indications were selected.
Results: Fifty-one patients underwent classic CRT and 52 patients underwent pHBP-CRT. In the classic CRT group, the median (interquartile range) basal LVEF was 30% (IQR, 29-35%) before implantation and 40% (35-48%) at follow-up. In the pHBP-CRT group, the median basal LVEF was 30% (28-34%) before implantation and 55% (45-60%) at follow-up, with significant differences between both modalities at follow-up (p = 0.001). The median long term His recruitment threshold with LBBB correction was 1.25 (1-2.5) V at 0.4 ms in cases of pHBP-CRT, compared to a left ventricular coronary sinus threshold of 1.25 (1-1.75) V in cases of classic CRT (p = 0.48). After CRT, the median paced QRS was 135 (120-145) ms for pHBP-CRT versus 140 (130-150) ms for BVP-CRT (p = 0.586).
Conclusions: The improvement in LVEF was superior with pHBP-CRT than with classic CRT. The thresholds at follow-up were similar in both groups.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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