The Effects of His Bundle Pacing Compared to Classic Resynchronization Therapy in Patients with Pacing-Induced Cardiomyopathy
Pacing-induced cardiomyopathy (PICM) is among the most common right ventricular pacing complications. Upgrading to cardiac resynchronization therapy (CRT) is the recommended treatment option. Conduction system pacing with His bundle pacing (HBP) has the potential to restore synchronous ventricular a...
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/19/5723 |
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| author | Rafal Gardas Krzysztof S. Golba Tomasz Soral Jolanta Biernat Piotr Kulesza Mateusz Sajdok Kamil Zub |
| author_facet | Rafal Gardas Krzysztof S. Golba Tomasz Soral Jolanta Biernat Piotr Kulesza Mateusz Sajdok Kamil Zub |
| author_sort | Rafal Gardas |
| collection | DOAJ |
| description | Pacing-induced cardiomyopathy (PICM) is among the most common right ventricular pacing complications. Upgrading to cardiac resynchronization therapy (CRT) is the recommended treatment option. Conduction system pacing with His bundle pacing (HBP) has the potential to restore synchronous ventricular activation and can be an alternative to biventricular pacing (BVP). Patients with PICM scheduled for a system upgrade to CRT were included in the prospective cohort study. Either HBP or BVP was used for CRT. Electrocardiographic, clinical, and echocardiographic measurements were recorded at baseline and six-month follow-up. HBP was successful in 44 of 53 patients (83%). Thirty-nine patients with HBP and 22 with BVP completed a 6-month follow-up. HBP led to a higher reduction in QRS duration than BVP, 118.3 ± 14.20 ms vs. 150.5 ± 18.64 ms, <i>p</i> < 0.0001. The improvement in New York Heart Association (NYHA) class by one or two was more common in patients with HBP than those with BiV (<i>p</i> = 0.04). Left ventricular ejection fraction (LVEF) improved in BVP patients from 32.9 ± 7.93% to 43.9 ± 8.07%, <i>p</i> < 0.0001, and in HBP patients from 34.9 ± 6.45% to 48.6 ± 7.73%, <i>p</i> < 0.0001. The improvement in LVEF was more considerable in HBP patients than in BVP patients, <i>p</i> = 0.019. The improvement in clinical outcomes and left ventricle reverse remodeling was more significant with HBP than BVP. HBP can be a valid alternative to BVP for upgrade procedures in PICM patients. |
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| publishDate | 2022-09-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-4c264b5f0f4f437394026957f15e819f2023-11-23T20:47:42ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011119572310.3390/jcm11195723The Effects of His Bundle Pacing Compared to Classic Resynchronization Therapy in Patients with Pacing-Induced CardiomyopathyRafal Gardas0Krzysztof S. Golba1Tomasz Soral2Jolanta Biernat3Piotr Kulesza4Mateusz Sajdok5Kamil Zub6Department of Electrocardiology, Leszek Giec Upper-Silesian Medical Centre, Silesian Medical University, 40-055 Katowice, PolandDepartment of Electrocardiology, Leszek Giec Upper-Silesian Medical Centre, Silesian Medical University, 40-055 Katowice, PolandDepartment of Electrocardiology, Leszek Giec Upper-Silesian Medical Centre, Silesian Medical University, 40-055 Katowice, PolandDepartment of Electrocardiology, Leszek Giec Upper-Silesian Medical Centre, Silesian Medical University, 40-055 Katowice, PolandDepartment of Electrocardiology, Leszek Giec Upper-Silesian Medical Centre, Silesian Medical University, 40-055 Katowice, PolandDepartment of Electrocardiology, Leszek Giec Upper-Silesian Medical Centre, Silesian Medical University, 40-055 Katowice, PolandDepartment of Electrocardiology, Leszek Giec Upper-Silesian Medical Centre, Silesian Medical University, 40-055 Katowice, PolandPacing-induced cardiomyopathy (PICM) is among the most common right ventricular pacing complications. Upgrading to cardiac resynchronization therapy (CRT) is the recommended treatment option. Conduction system pacing with His bundle pacing (HBP) has the potential to restore synchronous ventricular activation and can be an alternative to biventricular pacing (BVP). Patients with PICM scheduled for a system upgrade to CRT were included in the prospective cohort study. Either HBP or BVP was used for CRT. Electrocardiographic, clinical, and echocardiographic measurements were recorded at baseline and six-month follow-up. HBP was successful in 44 of 53 patients (83%). Thirty-nine patients with HBP and 22 with BVP completed a 6-month follow-up. HBP led to a higher reduction in QRS duration than BVP, 118.3 ± 14.20 ms vs. 150.5 ± 18.64 ms, <i>p</i> < 0.0001. The improvement in New York Heart Association (NYHA) class by one or two was more common in patients with HBP than those with BiV (<i>p</i> = 0.04). Left ventricular ejection fraction (LVEF) improved in BVP patients from 32.9 ± 7.93% to 43.9 ± 8.07%, <i>p</i> < 0.0001, and in HBP patients from 34.9 ± 6.45% to 48.6 ± 7.73%, <i>p</i> < 0.0001. The improvement in LVEF was more considerable in HBP patients than in BVP patients, <i>p</i> = 0.019. The improvement in clinical outcomes and left ventricle reverse remodeling was more significant with HBP than BVP. HBP can be a valid alternative to BVP for upgrade procedures in PICM patients.https://www.mdpi.com/2077-0383/11/19/5723conduction system pacingHis bundle pacingpacing-induced cardiomyopathycardiac resynchronization therapy |
| spellingShingle | Rafal Gardas Krzysztof S. Golba Tomasz Soral Jolanta Biernat Piotr Kulesza Mateusz Sajdok Kamil Zub The Effects of His Bundle Pacing Compared to Classic Resynchronization Therapy in Patients with Pacing-Induced Cardiomyopathy Journal of Clinical Medicine conduction system pacing His bundle pacing pacing-induced cardiomyopathy cardiac resynchronization therapy |
| title | The Effects of His Bundle Pacing Compared to Classic Resynchronization Therapy in Patients with Pacing-Induced Cardiomyopathy |
| title_full | The Effects of His Bundle Pacing Compared to Classic Resynchronization Therapy in Patients with Pacing-Induced Cardiomyopathy |
| title_fullStr | The Effects of His Bundle Pacing Compared to Classic Resynchronization Therapy in Patients with Pacing-Induced Cardiomyopathy |
| title_full_unstemmed | The Effects of His Bundle Pacing Compared to Classic Resynchronization Therapy in Patients with Pacing-Induced Cardiomyopathy |
| title_short | The Effects of His Bundle Pacing Compared to Classic Resynchronization Therapy in Patients with Pacing-Induced Cardiomyopathy |
| title_sort | effects of his bundle pacing compared to classic resynchronization therapy in patients with pacing induced cardiomyopathy |
| topic | conduction system pacing His bundle pacing pacing-induced cardiomyopathy cardiac resynchronization therapy |
| url | https://www.mdpi.com/2077-0383/11/19/5723 |
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