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Case Reports
. 2023 Jun 15;14(6):5488-5490.
doi: 10.19102/icrm.2023.14063. eCollection 2023 Jun.

Paradoxical Para-Hisian Pacing Response

Tolga Han Efe  1 , Idriz Merovci  2 , Muhammed Yunus Calapkulu  3 , Ceren Ozdemir Al  3 , Meryem Kara  3 , Duygu Kocyigit Burunkaya  3 , Elif Hande Ozcan Cetin  3 , Ahmet Korkmaz  3 , Ozcan Ozeke  3 , Serkan Cay  3 , Firat Ozcan  3 , Dursun Aras  4 , Serkan Topaloglu  3
Affiliations
Case Reports

Paradoxical Para-Hisian Pacing Response

Tolga Han Efe et al. J Innov Card Rhythm Manag. .

Abstract

Para-Hisian pacing (PHP) is among the most useful maneuvers in cardiac electrophysiology during sinus rhythm and identifies whether retrograde conduction is dependent on the atrioventricular (AV) node. In this maneuver, the retrograde activation time and pattern are compared during capture and loss of capture of the His bundle while pacing from a para-Hisian position. A common misconception about PHP is that it is useful only for septal accessory pathways (APs). However, even with left or right lateral pathways, as long as pacing from the para-Hisian region conducts to the atrium with the activation sequence being analyzed, it can be used to determine whether that activation is AV node-dependent or AP-dependent.

Keywords: Atrioventricular re-entrant tachycardia; elecrophysiological maneuvers; para-Hisian pacing.

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Conflict of interest statement

The authors report no conflicts of interest for the published content. No funding information was provided.

Figures

Figure 1:
Figure 1:
Three different QRS morphologies and ventriculoatrial intervals during para-Hisian pacing maneuver. Abbreviations: Cs d, coronary sinus distal; Cs p, coronary sinus proximal; His d, His distal; His p, His proximal.
See this image and copyright information in PMC

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