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Related Experiment Videos

Permanent parahisian pacing.

Eraldo Occhetta1, Miriam Bortnik, Paolo Marino

  • 1Divisione Clinicizzata di Cardiologia, Facolta di Medicina e Chirurgia, Universita degli Studi del Piemonte Orientale, Novara, Italy. occhetta@r-j.it

Indian Pacing and Electrophysiology Journal
|June 1, 2007
PubMed
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Parahisian pacing, a novel technique, effectively prevents negative hemodynamic effects from traditional right ventricular apical pacing. This method improves patient outcomes and preserves cardiac function, offering a superior alternative for pacemaker implantation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Right ventricular apical pacing can lead to adverse hemodynamic effects and desynchronization.
  • Physiologic pacing aims to maintain atrio-ventricular and interventricular synchronization.
  • Direct His Bundle Pacing (DHBP) is effective but complex and not universally applicable.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of parahisian pacing as an alternative to right ventricular apical pacing.
  • To assess the impact of parahisian pacing on hemodynamic function, patient quality of life, and cardiac function.

Main Methods:

  • A study involving 68 patients with advanced AV block and narrow QRS who received permanent right ventricular pacing in the hisian/parahisian region.
  • A double-blind randomized controlled study in 17 patients comparing parahisian and apical pacing over 6-month cross-over periods.

Related Experiment Videos

  • Long-term follow-up (mean 21 months/patient) in 51 patients to assess pacing thresholds and left ventricular function.

    • Main Results:

    • Parahisian pacing significantly improved NYHA class, exercise tolerance, quality of life, and reduced mitral/tricuspid regurgitation and interventricular mechanical delay compared to apical pacing.
    • Pacing thresholds remained stable during follow-up (p=0.08).
    • Left ventricular ejection fraction maintained stable medium-long term values, indicating prevention of functional deterioration.

    Conclusions:

    • Parahisian pacing is a reliable and easily applicable method for permanent right ventricular pacing.
    • This technique effectively prevents the negative hemodynamic and functional effects associated with non-physiological right ventricular apical pacing.
    • Parahisian pacing offers a physiological alternative, preserving cardiac function and improving patient outcomes.