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Updated: May 20, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Gender Differences for His Bundle Pacing Long-Term Performance in the Elderly Population.

Catalin Pestrea1, Ecaterina Cicala1, Dragos Lovin1

  • 1Department of Interventional Cardiology, Clinical County Emergency Hospital of Brasov, 500326 Brasov, Romania.

Journal of Cardiovascular Development and Disease
|March 26, 2025
PubMed
Summary
This summary is machine-generated.

His bundle pacing (HBP) is a safe and effective cardiac pacing method for elderly patients with atrioventricular (AV) block, showing no gender differences in long-term performance. Pacing thresholds may increase over time, necessitating regular follow-ups.

Keywords:
His bundle pacingelderlyfeasibilitygender differenceslong-term follow-up

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Geriatrics

Background:

  • His bundle pacing (HBP) offers physiological cardiac pacing.
  • Data on HBP in elderly populations, particularly regarding gender differences, are limited.
  • Atrioventricular (AV) block is a common indication for pacing in older adults.

Purpose of the Study:

  • To assess gender-specific long-term outcomes of His bundle pacing in elderly patients with AV block.
  • To identify factors influencing pacing threshold changes over time.
  • To evaluate the feasibility and safety of HBP in this demographic.

Main Methods:

  • Retrospective analysis of 73 patients over 65 years old with successful HBP and ≥2 years follow-up.
  • Comparison of baseline and follow-up clinical and procedural characteristics between genders.
  • Multivariate Cox regression to identify predictors of pacing threshold increase.

Main Results:

  • Successful HBP achieved in elderly patients, with narrower paced QRS durations in females.
  • Pacing thresholds increased significantly over two years in approximately one-third of patients, irrespective of gender.
  • Paced QRS duration, left ventricular ejection fraction, and ischemic cardiomyopathy predicted threshold increases.

Conclusions:

  • His bundle pacing is a feasible and effective long-term pacing strategy for elderly patients with AV block.
  • No significant gender differences were observed in HBP performance or threshold changes.
  • Regular monitoring is crucial to manage expected pacing threshold increases and optimize device function.