His-Purkinje Conduction System Pacing Following Transcatheter Aortic Valve Replacement

Vijayaraman, Pugazhendhi; Cano, Óscar; Koruth, Jacob S.; Subzposh, Faiz A.; Nanda, Sudip; Pugliese, Jessica; Ravi, Venkatesh; Naperkowski, Angela; Sharma, Parikshit S.

doi:10.1016/j.jacep.2020.02.010

Cited by 62 publications

(70 citation statements)

References 17 publications

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“…16,18 LBBP has the advantage of correcting the distal conduction system disease as the pacing lead effectively bypasses the diseased segment. 25 In patients undergoing AV junction ablation, LBBP provides adequate safety margin for ablation as the lead is away from AV node. As compared with the vast available clinical evidence with HBP, LBBP lacks long-term data on safety.…”

Section: Hbp Versus Lbbpmentioning

confidence: 99%

Left bundle branch pacing: A comprehensive review

Ponnusamy

Arora

Namboodiri

et al. 2020

Cardiovasc electrophysiol

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146

134

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Cardiac pacing is the only effective therapy for patients with symptomatic bradyarrhythmia. Traditional right ventricular apical pacing causes electrical and mechanical dyssynchrony resulting in left ventricular dysfunction, recurrent heart failure, and atrial arrhythmias. Physiological pacing activates the normal cardiac conduction, thereby providing synchronized contraction of ventricles. Though His bundle pacing (HBP) acts as an ideal physiological pacing modality, it is technically challenging and associated with troubleshooting issues during follow‐up. Left bundle branch pacing (LBBP) has been suggested as an effective alternative to overcome the limitations of HBP as it provides low and stable pacing threshold, lead stability, and correction of distal conduction system disease. This paper will focus on the implantation technique, troubleshooting, clinical implications, and a review of published literature of LBBP.

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Section: Hbp Versus Lbbpmentioning

confidence: 99%

Left bundle branch pacing: A comprehensive review

Ponnusamy

Arora

Namboodiri

et al. 2020

Cardiovasc electrophysiol

Self Cite

146

134

View full text Add to dashboard Cite

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“…HBP can be performed in patients developing AV block or left BB block (LBBB) after transcatheter aortic valve replacement (TAVR), but the success rate is limited. In a recent series of 65 patients, who underwent conduction system pacing implants post‐TAVR, HBP was successful in 29 of the 46 patients attempted (63%) 9 . HBP was more successful in patients with Edwards Sapiens valve than when compared with core valve 9 .…”

Section: Special Considerations—the Challenging Hbp Implantmentioning

confidence: 97%

His bundle pacing: Tips and tricks

Ravi

Baba

Sharma

2020

Pacing Clinical Electrophis

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His bundle (HB) pacing is an established modality for achieving physiological pacing with a low risk of long‐term lead‐related complications. The development of specially designed lead and delivery tools has improved the feasibility and safety of HB pacing (HBP). Knowledge of the anatomy of HB region and the variations is essential for successful implantation. Newer delivery systems have further improved procedural outcomes. Challenging implant cases can be successfully performed by reshaping the current sheaths, using “sheath in sheath” technique or “two‐lead implantation technique.” Special attention to the lead parameters at implant, programming, and follow‐up is necessary for successful long‐term outcomes with HBP. Widespread use of HBP by electrophysiologists and further advances in dedicated delivery systems and leads are essential to further improve the effectiveness of the implantation.

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“…In our experience, permanent His-bundle pacing was feasible in 63% of 46 patients with AV block post-TAVR, suggesting that the distal His bundle is intact in these patients. 12 If so, the true incidence of BBRT may be much higher than thought and under-recognized. Further research into the mechanisms of BBRT in patients with conduction disease post-TAVR is warranted.…”

Section: Can Bundle Branch Reentrant Tachycardia Occur In Patients Wimentioning

confidence: 99%

“…15 In our experience, His bundle pacing is more successful in patients with SAPIEN valves (Edwards Lifesciences, Irvine, CA, USA) than CoreValve systems (Medtronic, Minneapolis, MN, USA), while left bundle branch pacing is feasible in most patients post-TAVR. 12…”

Section: What Type Of Pacing Should Be Considered?mentioning

confidence: 99%