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His-bundle pacing from the right atrium: Solving pacemaker implantation challenges post-TriClip
Yoshimi Onishi1,2, Alberto Barengo1, Francesco Fioravanti1
1Cardiac Electrophysiology and Clinical Arrhythmology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Introduction:
This case report highlights the novel role of His-bundle pacing (HBP) from right atrium, not just for preserving cardiac function, but also for avoiding interference with TriClip devices.
Methods And Results:
A 78-year-old female with severe tricuspid regurgitation received two TriClip devices. Postprocedure, frequent significant sinus pauses required a pacemaker. HBP was chosen to avoid lead complications. Under local anesthesia, a His pacing lead was inserted via the axillary vein using specialized catheter. Follow-ups over 2.5 years showed stable parameters with no complications.
Conclusion:
HBP is effective for patients with TriClip devices, ensuring optimal cardiac function and lead stability.
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