Subvalvular His bundle pacing for pseudo-pacemaker syndrome and mitral regurgitation

Shah, Ruchit; Kumar, Vineet

doi:10.1016/j.hrcr.2018.06.008

Cited by 2 publications

(12 citation statements)

References 8 publications

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“…Apart from our case and the one published by Ogunlade et al 6 . where no clear association between the patient’s past medical history and the presence of PPMS could be found, four etiologies of PPMS were identified in the remaining cases (n. 15), as follows: (1) Idiopathic PPMS related to poor AV nodal conduction (20% of cases); 2,14,16 (2) reversible inflammatory causes (13%) such as acute myocarditis 15 or acute rheumatic fever; 13 (3) cardiac surgery, 20 interventional procedures 11 or chest radiation 17 leading to the permanent damage of the normal AV conduction system (20%), and, finally, (4) PPMS due to manifest dual AV nodal physiology (DAVNP) occurring as a primary finding (27%) 10,12,16,19 or post slow pathway ablation for treatment of AVNRT (20%) 10,18,21 . In fact, in this latter group, two patients (66%) had residual DAVNP due to damage to the fast pathway, either as a complication of slow pathway ablation 21 or deliberate ablation as a treatment option for AVNRT 10 .…”

Section: Resultsmentioning

confidence: 40%

“…In fact, in this latter group, two patients (66%) had residual DAVNP due to damage to the fast pathway, either as a complication of slow pathway ablation 21 or deliberate ablation as a treatment option for AVNRT 10 . However, one case (33%) developed PPMS after AVNRT not related to DAVNP but rather to poor AV nodal conduction 18 …”

Section: Resultsmentioning

confidence: 94%

“…None of the patients developed high‐degree AV block, and only one patient developed blocked premature atrial contractions 19 . However, the stress test was able to reproduce the presenting symptoms of PPMS in about five (70%) cases 2,14,16–18 . Prolongation of the PR interval during the stress test was reported in four cases 14,16,17,19 out of whom 50% had DAVNP.…”

Section: Resultsmentioning

confidence: 98%

“…The retrieved 17 cases of PPMS—including our case report—are outlined in Table 1 2,6,10,12–21 . Most (88.2%) were adults with an average age of 47 years ranging from 13 to 86 years old.…”

Section: Resultsmentioning

confidence: 99%

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Pseudo‐pacemaker syndrome with prolonged PR interval: A narrative review

Feliz

Luciano

Guevara

et al. 2023

Pacing Clinical Electrophis

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Pseudo‐pacemaker syndrome (PPMS) is a rare complication of first‐degree atrio‐ventricular (AV) block in which a very prolonged PR interval causes AV dyssynchrony and subsequent symptoms of hemodynamic instability in the absence of an implanted pacemaker. The aim of this manuscript was to describe a unique case of PPMS and to provide a comprehensive review of the topic to help clinicians in the diagnosis and management of this condition. Through systematic research on PubMed, Google Scholar, EBSCO, and Ovid MEDLINE and using the search strings “pseudo‐pacemaker syndrome” and “symptomatic first‐degree AV block,” we identified 14 articles accounting for 17 cases of PPMS, including our case report. The most common age group for PPMS was middle‐aged and young adults, with an average age of 47 years. Palpitations were the most common presenting symptom and four main etiologies of PPMS were identified, as follows: (1) Idiopathic PPMS with evidence of impaired conduction over the AV node (20% of cases), (2) PPMS associated with reversable inflammatory causes (13%) or (3) associated with iatrogenic surgical or interventional procedures leading to the permanent damage of the normal AV conduction system (20%), and, finally, (4) PPM related to dual AV nodal physiology (DAVNP) as a primary finding (27%) or occurring after fast or slow pathway ablation for treatment of AV nodal re‐entrant tachycardia (AVNRT) (20%). Treatment should be patient‐tailored and based on the specific etiology once identified. However, the treatment of PPMS due to DAVNP without AVNRT presentation is yet to be clarified.

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Section: Resultsmentioning

confidence: 40%

Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

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Pseudo‐pacemaker syndrome with prolonged PR interval: A narrative review

Feliz

Luciano

Guevara

et al. 2023

Pacing Clinical Electrophis

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“…Thus, the visualization of the TVA and the root of the septal leaflet described in the present investigation makes it possible to place the pacing lead helix at the His bundle on either the atrial or ventricular side as we described. Few previous reports have revealed the pacing site under the septal leaflet that was either retrospectively confirmed by postoperative echocardiography or computed tomography scan or by prosthetic cardiac valves . The study by Sharma et al first reported using the prosthetic cardiac valve as an anatomic landmark for localizing the His bundle region and improving the HBP implantation in the ventricular side.…”

Section: Discussionmentioning

confidence: 99%

Visualization of tricuspid valve annulus for implantation of His bundle pacing in patients with symptomatic bradycardia

Hua

et al. 2019

Cardiovasc electrophysiol

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Background His bundle pacing (HBP) is a physiological pacing modality, but HBP implantation remains a challenge. Objective This study explored the feasibility of using visualization of the tricuspid valve annulus (TVA) to locate the site for HBP. Methods During the lead placement in eight patients with symptomatic bradycardia, the TVA and tricuspid septal leaflet was revealed by contrast injection in the right ventricle under the fluoroscopic right anterior oblique view, and the target site for HBP was identified near the intersection of the tricuspid septal leaflet and the interventricular septum. On the basis of the imaging marker, the pacing lead was placed for HBP at either the atrial (aHBP) or ventricular side (vHBP). Results During the implantation, the pacing lead placement was attempted for aHBP in two patients, vHBP in five patients, and first for aHBP then vHBP in one patient. The aHBP was selective and had a capture threshold of 1.6 ± 0.5 V@ 1.0ms and R‐wave amplitude of 1.2 ± 0.4 mV. Ventricular‐side His bundle capture was selective in four patients and nonselective in two patients. The vHBP capture threshold was 0.8 ± 0.4 V@ 1.0ms (P < .05 vs aHBP) and R‐wave amplitude was 4.1 ± 1.5 mV (P < .05 vs aHBP). At the final pacing programming of 3.0 V@ 1.0ms, vHBP was nonselective in all six patients and aHBP remained selective in two patients. Pacing parameters remained stable at 3 months. Conclusion The location of the TVA and tricuspid septal leaflet revealed by right ventriculography can be used as a landmark to identify the HBP site.

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Subvalvular His bundle pacing for pseudo-pacemaker syndrome and mitral regurgitation

Cited by 2 publications

References 8 publications

Pseudo‐pacemaker syndrome with prolonged PR interval: A narrative review

Pseudo‐pacemaker syndrome with prolonged PR interval: A narrative review

Visualization of tricuspid valve annulus for implantation of His bundle pacing in patients with symptomatic bradycardia

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