CONDUCTION BLOCK CORRECTED WITH PARA-HISIAN PACING BUT HEMODYNAMIC RESPONSE COMPARABLE TO BIV PACING IN PATIENTS WITH HF AND LBBB
F. Ayala-Paredes, R. Barba-Pichardo, P. Morina-Vazquez, J.M. Fernández-Gómez, H.F. Tse, J. Neuzner, R. Yee, A. Shuros, S. Hahn, A. Sharma, J. Ding, L. Manola, C. Butter
Université de Sherbrooke, Sherbrooke, Canada (F.A.P); Hospital Juan Ramón Jiménez de Huelva, Huelva, Spain (R.B.P, P.M.V, J.M.F.G); University of Hong Kong, Hong Kong, Hong Kong (H.F.T); Klinikum Kassel, Kassel, Germany (J.N); University of Western Ontario (R.Y); Boston Scientific, Saint Paul, USA (A.S, S.H, A.S, J.D, L.M); Immanuel Klinikum Bernau Herzzentrum Brandenburg, Bernau, Germany (C.B)
Introduction: Studies suggest pacing from the para-Hisian region can correct LBBB in patients with HF, but unlike conventional biventricular pacing (BiV), little is known of the acute hemodynamic response to para-Hisian pacing (PHP). The purpose of this study is to compare acute hemodynamics during BiV and PHP.
Methods: Fourteen patients undergoing de novo CRT implant were studied. Along with standard CRT lead implant, a pacing catheter was placed in the His bundle region and a pressure sensor in the LV. Signals were recorded during periods of BiV and PHP.
Results: Conduction correction with PHP was evident in 6 of 14 patients (43%). The mean percent improvement in peak LV dP/dt for BiV and PH paced beats was 23.0±3.2% and 21.3±1.58% (P=NS), respectively.
Conclusions: In patients exhibiting conduction correction, the hemodynamic response was comparable between PHP and BiV. This suggests that PHP may be of value in the treatment of heart failure and conduction disease.
