Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2015 Feb;12(2):305-12.
doi: 10.1016/j.hrthm.2014.10.021. Epub 2014 Oct 22.

Permanent His-bundle pacing is feasible, safe, and superior to right ventricular pacing in routine clinical practice

Parikshit S Sharma  1 , Gopi Dandamudi  1 , Angela Naperkowski  1 , Jess W Oren  2 , Randle H Storm  2 , Kenneth A Ellenbogen  3 , Pugazhendhi Vijayaraman  4
Affiliations
Multicenter Study

Permanent His-bundle pacing is feasible, safe, and superior to right ventricular pacing in routine clinical practice

Parikshit S Sharma et al. Heart Rhythm. 2015 Feb.

Abstract

Background: Right ventricular pacing (RVP) has been associated with heart failure and increased mortality. His-bundle pacing (HBP) is more physiological but requires a mapping catheter or a backup right ventricular lead and is technically challenging.

Objective: We sought to assess the feasibility, safety, and clinical outcomes of permanent HBP in an unselected population as compared to RVP.

Methods: All patients requiring pacemaker implantation routinely underwent attempt at permanent HBP using the Select Secure (model 3830) pacing lead in the year 2011 delivered through a fixed-shaped catheter (C315 HIS) at one hospital and RVP at the second hospital. Patients were followed from implantation, 2 weeks, 2 months, 1 year, and 2 years. Fluoroscopy time (FT), pacing threshold (PTh), complications, heart failure hospitalization, and mortality were compared.

Results: HBP was attempted in 94 consecutive patients, while 98 patients underwent RVP. HBP was successful in 75 patients (80%). FT was similar (12.7 ± 8 minutes vs 10 ± 14 minutes; median 9.1 vs 6.4 minutes; P = .14) and PTh was higher in the HBP group than in the RVP group (1.35 ± 0.9 V vs 0.6 ± 0.5 V at 0.5 ms; P < .001) and remained stable over a 2-year follow-up period. In patients with >40% ventricular pacing (>60% of patients), heart failure hospitalization was significantly reduced in the HBP group than in the RVP group (2% vs 15%; P = .02). There was no difference in mortality between the 2 groups (13% in the HBP group vs 18% in the RVP group; P = .45).

Conclusion: Permanent HBP without a mapping catheter or a backup right ventricular lead was successfully achieved in 80% of patients. PTh was higher and FT was comparable to those of the RVP group. Clinical outcomes were better in the HBP group than in the RVP group.

Keywords: Clinical outcomes; Feasibility; Heart failure; His-bundle pacing; Para-Hisian pacing; Right ventricular pacing; Safety.

PubMed Disclaimer

MeSH terms

LinkOut - more resources