Direct His-Bundle Pacing Improved Left Ventricular Function and Remodelling in a Biventricular Pacing Nonresponder
Peiren Shan1, Lan Su1, Xiao Chen1
1Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
The Canadian Journal of Cardiology
|February 23, 2016
Summary
Direct His bundle pacing improved a heart failure patient's condition after atrioventricular junction ablation for atrial fibrillation. This cardiac pacing method offers an alternative for non-responders to biventricular pacing.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Optimal pacing strategy post-atrioventricular junction (AVJ) ablation for chronic atrial fibrillation is not well-defined.
- Cardiac resynchronization therapy (CRT) is used in heart failure patients, but response can vary.
Observation:
- A heart failure patient with chronic atrial fibrillation underwent AVJ ablation and received a CRT-defibrillator.
- The patient showed no clinical improvement with standard biventricular pacing.
Findings:
- Revision of the device to include direct His bundle pacing led to significant functional status improvement.
- Left ventricular indices also showed marked enhancement after direct His bundle pacing implementation.
Implications:
- Direct His bundle pacing presents a viable alternative to biventricular pacing for CRT non-responders post-AVJ ablation.
- This approach may be particularly beneficial for patients with an intact distal conduction system.
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