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Mid-term performance of His bundle pacing and usefulness of backup leads

Julia Herbert1, Arianne Kovacsovics1, Rita Brito1

  • 1Cardiac Pacing Unit, Department of Cardiology, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva, Switzerland.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|June 14, 2024
PubMed

Insights

Adding ventricular backup leads to His bundle pacing (HBP) may reduce lead revisions and adverse events. This study suggests backup leads are beneficial for selected HBP patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • His bundle pacing (HBP) is an alternative pacing strategy.
  • The utility of ventricular backup leads in HBP is not well-established.

Purpose of the Study:

  • To evaluate the effectiveness of ventricular backup leads in patients undergoing His bundle pacing.
  • To determine if backup leads reduce lead revision rates and adverse events.

Main Methods:

  • Retrospective study of 184 patients with His bundle pacing.
  • Analysis of lead revision rates and adverse events in patients with and without backup leads.

Main Results:

  • 147 (79.9%) patients maintained His bundle capture at follow-up.
  • Lead revision occurred in 13.9% of patients without backup leads versus 2.0% with backup leads (P = 0.008).
  • One patient without a backup lead experienced syncope due to atrial oversensing.

Conclusions:

  • Implantation of ventricular backup leads may be beneficial for selected His bundle pacing patients.
  • Backup leads can potentially reduce the need for lead revisions and prevent adverse events.

Keywords:
Adverse eventsBackup leadConduction system pacingHis bundle pacingLead revision

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