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Electrical parameters with His-bundle pacing: Considerations for automated programming.

Neasa Starr1, Nicolas Dayal1, Giulia Domenichini1

  • 1Cardiology Department, University Hospital of Geneva, Geneva, Switzerland.

Heart Rhythm
|August 5, 2019
PubMed
Summary
This summary is machine-generated.

Programming His-bundle pacing is complex. This study found lower thresholds with unipolar pacing, but programming requires careful consideration of electrical parameters for optimal device function.

Keywords:
Capture thresholdsHis bundle pacingOptimizationProgrammingTiming

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Current implantable pulse generators present challenges for programming His-bundle pacing.
  • His-bundle pacing requires specialized programming due to device design limitations.

Purpose of the Study:

  • To evaluate electrical parameters for His-bundle pacing.
  • To propose preset programming configurations for His-bundle pacing.

Main Methods:

  • Collected data from 50 patients undergoing His-bundle pacing lead interrogation.
  • Assessed capture thresholds, timing intervals, and automatic threshold algorithm performance.
  • Utilized various pacing vectors and lead port configurations (atrial, RV, LV).

Main Results:

  • Unipolar His-bundle pacing showed significantly lower thresholds than bipolar/extended bipolar.
  • His pace-right ventricular sensed intervals averaged 85 ± 25 ms, with longer delays in specific patient groups.
  • Automatic threshold algorithms performed variably and did not differentiate His from myocardial capture.

Conclusions:

  • Findings provide data to optimize automated programming for His-bundle pacing.
  • Simplified device management through data-driven programming settings is achievable.