Hemodynamic Effects of Permanent His Bundle Pacing Compared to Right Ventricular Pacing Assessed by Two-Dimensional Speckle-Tracking Echocardiography

Jedrzej Michalik, Alicja Dabrowska-Kugacka, Katarzyna Kosmalska, Roman Moroz, Adrian Kot, Ewa Lewicka and Marek Szolkiewicz
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Jedrzej Michalik: Kashubian Center for Heart and Vascular Diseases, Department of Cardiology and Interventional Angiology, Pomeranian Hospitals, 84-200 Wejherowo, Poland
Alicja Dabrowska-Kugacka: Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-214 Gdansk, Poland
Katarzyna Kosmalska: Department of Cardiology, Pomeranian Hospitals, 81-348 Gdynia, Poland
Roman Moroz: Kashubian Center for Heart and Vascular Diseases, Department of Cardiology and Interventional Angiology, Pomeranian Hospitals, 84-200 Wejherowo, Poland
Adrian Kot: Kashubian Center for Heart and Vascular Diseases, Department of Cardiology and Interventional Angiology, Pomeranian Hospitals, 84-200 Wejherowo, Poland
Ewa Lewicka: Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-214 Gdansk, Poland
Marek Szolkiewicz: Kashubian Center for Heart and Vascular Diseases, Department of Cardiology and Interventional Angiology, Pomeranian Hospitals, 84-200 Wejherowo, Poland

IJERPH, 2021, vol. 18, issue 21, 1-9

Abstract: We compared the effects of right ventricular (RVP; n = 26) and His bundle (HBP; n = 24) pacing in patients with atrioventricular conduction disorders and preserved LVEF. Postoperatively (1D), and after six months (6M), the patients underwent global longitudinal strain (GLS) and peak systolic dispersion (PSD) evaluation with 2D speckle-tracking echocardiography, assessment of left atrial volume index (LAVI) and QRS duration (QRSd), and sensing/pacing parameter testing. The RVP threshold was lower than the HBP threshold at 1D (0.65 ± 0.13 vs. 1.05 ± 0.20 V, p < 0.001), and then it remained stable, while the HBP threshold increased at 6M (1.05 ± 0.20 vs. 1.31 ± 0.30 V, p < 0.001). The RVP R-wave was higher than the HBP R-wave at 1D (11.52 ± 2.99 vs. 4.82 ± 1.41 mV, p < 0.001). The RVP R-wave also remained stable, while the HBP R-wave decreased at 6M (4.82 ± 1.41 vs. 4.50 ± 1.09 mV, p < 0.02). RVP QRSd was longer than HBP QRSd at 6M (145.0 ± 11.1 vs. 112.3 ± 9.3 ms, p < 0.001). The absolute value of RVP GLS decreased at 6M (16.32 ± 2.57 vs. 14.03 ± 3.78%, p < 0.001), and HBP GLS remained stable. Simultaneously, RVP PSD increased (72.53 ± 24.15 vs. 88.33 ± 30.51 ms, p < 0.001) and HBP PSD decreased (96.28 ± 33.99 vs. 84.95 ± 28.98 ms, p < 0.001) after 6 months. RVP LAVI increased (26.73 ± 5.7 vs. 28.40 ± 6.4 mL/m 2 , p < 0.05), while HBP LAVI decreased at 6M (30.03 ± 7.8 vs. 28.73 ± 8.7 mL/m 2 , p < 0.01). These results confirm that HBP does not disrupt ventricular synchrony and provides advantages over RVP.

Keywords: His bundle pacing; ventricular synchrony; 2D speckle-tracking echocardiography; global longitudinal strain; left atrial volume (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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