| Popis: |
His bundle pacing (HBP) maintains a physiological activation pattern of ventricular activation, and in patients with intraventricular conduction delay (IVCD) it can normalize wide QRS duration.A total of 181 patients from the HBP registry were enrolled into a the study, which was conducted at the Department of Electrocardiology in Katowice, Poland. The patients had left ventricular ejection fraction (LVEF)50% and were implanted between November 2015 and April 2019. The HBP indications were as follows: 1) bradycardia and atrioventricular conduction disturbances with expected high pacing burden, 2) IVCD, LVEF ≤ 35%, with an indication for resynchronization therapy, 3) the need to upgrade to resynchronization therapy due to pacing-induced cardiomyopathy. Pacing parameters and echocardiographic and clinical data were assessed for up to 2 years of follow-up (FU).His bundle pacing was successful in 154 (85.1%) patients. Eighty-two patients completed a 6-month FU. The mean age was 70.6 ± 9.23 years, and 79% were males. At 6 months FU LVEF improved from 35.3 ± 8.22% to 43.1 ± 10.14% (p0.0001), and indexed left ventricular end-systolic volume (LVESVi) decreased from 63.1 ± 25.21 mL/m² to 51.9 ± 22.79 mL/m² (p0.0001). In 53.1%, the LVESVi reduction was greater than 15%. The improvement in LVEF and LVESVi was also observed after 24 months of FU.His bundle pacing in permanently paced patients when LVEF is reduced below 50% is associated with improvement in LVEF and reverse left ventricle remodeling. |
