Abstract
This report demonstrates the feasibility of pacing the left bundle branch (LBB) immediately
beyond the conduction block to functionally restore the impaired His-Purkinje conduction
system in a patient with heart failure and left bundle branch block (LBBB). The pacing
required only a low pacing output (0.5 volts/0.5 ms) to correct the LBBB with accompanying
right BBB on the electrocardiogram. Over 1-year of follow-up, the patient had a significant
improvement in clinical outcome and echocardiographic measurements. The case shows
a novel pacing strategy for patients with BBB that affects many patients with heart
failure.
Résumé
Le présent rapport démontre la faisabilité de la stimulation de la branche gauche
(BG) immédiatement après le bloc de conduction pour restaurer de manière fonctionnelle
le système de conduction de His et Purkinje chez un patient qui présente une insuffisance
cardiaque et un bloc de branche gauche (BBG). La stimulation a seulement exigé une
faible sortie de stimulation (0,5 volts/0,5 ms) pour corriger le BBG associé au BB
droit à l’électrocardiogramme. Au cours du suivi de 1 an, le patient a connu une nette
amélioration des résultats cliniques et des mesures échocardiographiques. Ce cas montre
une nouvelle stratégie de stimulation chez les patients présentant un BB (qui touche
un grand nombre de patients atteints d’insuffisance cardiaque).
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References
- Pacing and sensing optimization of permanent His-bundle pacing in cardiac resynchronization therapy/implantable cardioverter defibrillators patients: value of integrated bipolar configuration.Europace. 2016; 18: 1399-1405
- Permanent His bundle pacing for cardiac resychronization therapy: initial feasibility study in lieu of left ventricular lead.Heart Rhythm. 2017; 14: 1353-1361
- His-bundle pacing versus biventricular pacing in cardiac resynchronization therapy patients: a crossover design comparison.Heart Rhythm. 2015; 12: 1548-1557
- Benefits of permanent His Bundle pacing combined with atrioventricular node ablation in atrial fibrillation patients with heart failure with both preserved and reduced left ventricular ejection fraction.J Am Heart Assoc. 2017; 6: e005309
Article info
Publication history
Published online: September 21, 2017
Accepted:
September 11,
2017
Received:
August 10,
2017
Footnotes
See page 1736.e3 for disclosure information.
Identification
Copyright
© 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
