Assessment of Permanent Selective His Bundle Pacing in Left Ventricular Synchronization Using 3-D Speckle Tracking Echocardiography

Tang, Jiaojiao; Chen, Silin; Liu, Lie; Liao, Hongtao; Zhan, Xianzhang; Wu, Shu‐Lin; Chen, Oudi; Lin, Chunying; Zhang, Qianhuan; Wei, Hui‐Qiang; Chen, Dongli

doi:10.1016/j.ultrasmedbio.2018.10.006

Cited by 6 publications

(6 citation statements)

References 30 publications

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“…In the HBP group, the R-wave was significantly lower immediately after the procedure, and it decreased further after six months. Similar differences were noticed in previous studies [ 13 , 14 ]. Group differences in the observed values do not, however, arouse any practical concern.…”

Section: Discussionsupporting

confidence: 91%

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

Michalik¹,

Dąbrowska−Kugacka

Kosmalska

et al. 2021

IJERPH

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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/m2, p < 0.05), while HBP LAVI decreased at 6M (30.03 ± 7.8 vs. 28.73 ± 8.7 mL/m2, p < 0.01). These results confirm that HBP does not disrupt ventricular synchrony and provides advantages over RVP.

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Section: Discussionsupporting

confidence: 91%

“…Similar conclusions have been presented in previous studies. Tang et al showed a significantly greater PSD in the RVP group than in the HBP group as early as one week after the procedure [ 14 ]. Sun et al observed significantly greater PSD values in the RVP group compared with the left bundle branch pacing (LBBP) group [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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

Michalik¹,

Dąbrowska−Kugacka

Kosmalska

et al. 2021

IJERPH

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“…Conventional pacing therapy places the pacemaker lead in the right ventricular apex or septum, with ventricular pacing forming a wide QRS wave and unsynchronized contraction. The His bundle‐Purkinje conduction system ensures rapid activation in both ventricles and synchronized contraction 12 . Thus, physiological pacing should utilize the natural His bundle‐Purkinje conduction system.…”

Section: Discussionmentioning

confidence: 99%

“…The His bundle-Purkinje conduction system ensures rapid activation in both ventricles and synchronized contraction. 12…”

Section: Discussionmentioning

confidence: 99%

Assessment of ventricular mechanical synchronization after left bundle branch pacing using 2‐D speckle tracking echocardiography

Sun

Gao

et al. 2020

Clinical Cardiology

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Background: The left bundle branch pacing (LBBP) makes the ventricular depolarization closer to the physiological state and shortens QRS duration. The purpose of this study is to explore the ventricular systolic mechanical synchronization after LBBP in comparison with traditional right ventricular pacing (RVP) using two-dimensional strain echocardiography (2D-STE). Methods: Thirty-two patients who received LBBP (n = 16) or RVP (n = 16) from October 2018 to October 2019 and met the inclusion criteria were included in this retrospective study. Electrocardiogram (ECG) characteristics, pacing parameters, pacing sites, and safety events were assessed before and after implantation. Acquisition and analysis of ventricular systolic synchronization were implemented using 2D-STE. Results: In RVP group, ECG showed left bundle branch block patterns. At LBBP, QRS morphology was in the form of right bundle branch block, and QRS durations were significantly shorter than that of the RVP QRS (109.38 ± 12.89 vs 149.38 \ ± 19.40 ms, P < .001). Both the maximum time differences (TD) and SDs of the 18-segments systolic time to peak systolic strain were significantly shorter under

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“…A total of 2182 articles were identified through initial database search, of which 713 duplicates and 1407 irrelevant records were excluded via title and abstract screening (Figure 1). After a full‐text assessment of the remaining 62 articles, we ultimately included 28 studies for further analysis 19‐46 . Overall, 4160 patients were involved with a mean age of 70.9 years, comprising 2379 (57.2%) men and 1781 (42.8%) women.…”

Section: Resultsmentioning

confidence: 99%

His‐Purkinje conduction system pacing: A systematic review and network meta‐analysis in bradycardia and conduction disorders

Sun

Zhang

et al. 2021

Cardiovasc electrophysiol

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Background His‐Purkinje conduction system pacing (HPCSP) has emerged as an effective alternative to overcome the limitations of right ventricular pacing (RVP) via physiological left ventricular activation, but there remains a paucity of comparative information for His bundle pacing (HBP) and left bundle branch pacing (LBBP). Methods A Bayesian random‐effects network analysis was conducted to compare the relative effects of HBP, LBBP, and RVP in patients with bradycardia and conduction disorders. PubMed, Embase, Cochrane Library, and Web of Science were systematically searched from database inception until September 21, 2021. Results Twenty‐eight studies involving 4160 patients were included in this meta‐analysis. LBBP significantly improved success rate, pacing threshold, pacing impedance, and R‐wave amplitude compared with HBP. LBBP also demonstrated a nonsignificant trend towards superior outcomes of lead complications, heart failure hospitalization, atrial fibrillation, and all‐cause death. However, HBP was associated with significantly shorter paced QRS duration relative to LBBP. Despite higher success rates, shorter procedure/fluoroscopy duration, and fewer lead complications, patients receiving RVP were more likely to experience reduced left ventricular ejection fraction, longer paced QRS duration, and higher rates of heart failure hospitalization than those receiving HPCSP. No statistical differences were observed in the remaining outcome measures. Conclusions This network meta‐analysis demonstrates the efficacy and safety of HPCSP for the treatment of bradycardia and conduction disorders, with differences in pacing parameters, electrophysiology characteristics, and clinical outcomes between HBP and LBBP. Larger‐scale, long‐term comparative studies are warranted for further verification.

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Assessment of Permanent Selective His Bundle Pacing in Left Ventricular Synchronization Using 3-D Speckle Tracking Echocardiography

Cited by 6 publications

References 30 publications

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

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

Assessment of ventricular mechanical synchronization after left bundle branch pacing using 2‐D speckle tracking echocardiography

His‐Purkinje conduction system pacing: A systematic review and network meta‐analysis in bradycardia and conduction disorders

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