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His bundle electrograms in 51 patients requiring permanent transvenous pacemakers
The Journal of Thoracic and Cardiovascular Surgery
|July 1, 1977
Summary
His bundle electrograms were not helpful for selecting pacemaker candidates in sick sinus syndrome. However, they are crucial for identifying patients with chronic bundle branch block who require a pacemaker.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Pacing
Background:
- Syncope and dizziness are common symptoms necessitating pacemaker implantation.
- Sick sinus syndrome and various degrees of heart block are frequent indications for permanent pacemakers.
Purpose of the Study:
- To evaluate the utility of His bundle electrograms (HBE) in identifying patients who would benefit from permanent pacemaker implantation.
- To assess the role of HBE in patients with sick sinus syndrome and heart block prior to pacemaker implantation.
Main Methods:
- Fifty-one patients underwent His bundle electrogram studies before permanent pacemaker implantation.
- Studies included sinoatrial (SA) node recovery times and pacing/sensing threshold measurements.
- Analysis focused on the diagnostic value of HBE in different cardiac conditions.
Main Results:
- His bundle electrogram was not particularly helpful in selecting pacemaker candidates for the overall patient group.
- Twenty-eight patients had sick sinus syndrome; HBE was disappointing in detecting abnormalities.
- A prolonged H-V interval on HBE was indicative of pacemaker need in symptomatic chronic bundle branch block patients.
Conclusions:
- His bundle electrogram is not a reliable tool for selecting pacemaker candidates in sick sinus syndrome.
- Symptomatic patients with second- or third-degree heart block unequivocally require a pacemaker.
- His bundle electrogram plays a significant role in managing symptomatic chronic bundle branch block, guiding pacemaker therapy via H-V interval assessment.