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Selective His-bundle pacing in an adult with atrioventricular canal defect via retrograde His localization

Adult congenital heart disease patients may undergo numerous fluoroscopically guided procedures including pacemaker implantation during their lifetime. One alternative to traditional pacemaker setup which may improve long-term pacing outcomes is His bundle pacing. Given the altered His-bundle locati...

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Autores principales: Bury, Anastasia, Cortez, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8414309/
https://www.ncbi.nlm.nih.gov/pubmed/34089841
http://dx.doi.org/10.1016/j.ipej.2021.05.009
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author Bury, Anastasia
Cortez, Daniel
author_facet Bury, Anastasia
Cortez, Daniel
author_sort Bury, Anastasia
collection PubMed
description Adult congenital heart disease patients may undergo numerous fluoroscopically guided procedures including pacemaker implantation during their lifetime. One alternative to traditional pacemaker setup which may improve long-term pacing outcomes is His bundle pacing. Given the altered His-bundle location, and given increased radiation exposure over a lifetime, we used 3-dimensional mapping to locate the His and to minimize fluoroscopy for placement of a His-bundle pacemaker system in a 31-year old patient with atrioventricular canal defect and complete heart block with 100% RV pacing and epicardial lead fracture. METHODS: An Octapolar Livewire catheter (Abbott, Minneapolis, USA) was used for mapping and location of the His bundle from a right femoral venous access on the EnSite Precision system 3-dimensional mapping system (Abbott Medical, Abbott Park, IL). The same map was used to guide 3830 lead placement into the posterior-inferior His-bundle position. RESULTS: Successful placement of a His-bundle pacing system with thresholds of 1Volt@0.4ms for both the atrial and ventricular leads with selective His-bundle pacing noted. Ten-month follow-up demonstrated His-bundle capture at 0.75V@0.4ms with stable impedance, sensing and with 100% right ventricular pacing a projected longevity of 12 years total. CONCLUSIONS: Successful placement of selective His-bundle pacing can be achieved in an adult patient with atrioventricular canal defect using 3-dimensional mapping.
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spelling pubmed-84143092021-09-08 Selective His-bundle pacing in an adult with atrioventricular canal defect via retrograde His localization Bury, Anastasia Cortez, Daniel Indian Pacing Electrophysiol J Case Report Adult congenital heart disease patients may undergo numerous fluoroscopically guided procedures including pacemaker implantation during their lifetime. One alternative to traditional pacemaker setup which may improve long-term pacing outcomes is His bundle pacing. Given the altered His-bundle location, and given increased radiation exposure over a lifetime, we used 3-dimensional mapping to locate the His and to minimize fluoroscopy for placement of a His-bundle pacemaker system in a 31-year old patient with atrioventricular canal defect and complete heart block with 100% RV pacing and epicardial lead fracture. METHODS: An Octapolar Livewire catheter (Abbott, Minneapolis, USA) was used for mapping and location of the His bundle from a right femoral venous access on the EnSite Precision system 3-dimensional mapping system (Abbott Medical, Abbott Park, IL). The same map was used to guide 3830 lead placement into the posterior-inferior His-bundle position. RESULTS: Successful placement of a His-bundle pacing system with thresholds of 1Volt@0.4ms for both the atrial and ventricular leads with selective His-bundle pacing noted. Ten-month follow-up demonstrated His-bundle capture at 0.75V@0.4ms with stable impedance, sensing and with 100% right ventricular pacing a projected longevity of 12 years total. CONCLUSIONS: Successful placement of selective His-bundle pacing can be achieved in an adult patient with atrioventricular canal defect using 3-dimensional mapping. Elsevier 2021-06-02 /pmc/articles/PMC8414309/ /pubmed/34089841 http://dx.doi.org/10.1016/j.ipej.2021.05.009 Text en © 2021 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Bury, Anastasia
Cortez, Daniel
Selective His-bundle pacing in an adult with atrioventricular canal defect via retrograde His localization
title Selective His-bundle pacing in an adult with atrioventricular canal defect via retrograde His localization
title_full Selective His-bundle pacing in an adult with atrioventricular canal defect via retrograde His localization
title_fullStr Selective His-bundle pacing in an adult with atrioventricular canal defect via retrograde His localization
title_full_unstemmed Selective His-bundle pacing in an adult with atrioventricular canal defect via retrograde His localization
title_short Selective His-bundle pacing in an adult with atrioventricular canal defect via retrograde His localization
title_sort selective his-bundle pacing in an adult with atrioventricular canal defect via retrograde his localization
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8414309/
https://www.ncbi.nlm.nih.gov/pubmed/34089841
http://dx.doi.org/10.1016/j.ipej.2021.05.009
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