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Can permanent His bundle pacing be safely started by operators new to this technique? Data from a multicenter registry
Author(s) -
Chaumont Corentin,
Auquier Nathanael,
Milhem Antoine,
Mirolo Adrian,
Al Arnaout Alain,
Popescu Elena,
Viart Guillaume,
Godin Bénédicte,
Gillibert André,
Savouré Arnaud,
Eltchaninoff Hélène,
Anselme Frédéric
Publication year - 2021
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14860
Subject(s) - medicine , qrs complex , fluoroscopy , implant , cardiology , heart rhythm , atrial fibrillation , ventricular pacing , cardiac resynchronization therapy , bundle , heart failure , surgery , ejection fraction , materials science , composite material
Background Right ventricular pacing (RVP) induces ventricular asynchrony in patients with normal QRS and increases the risk of heart failure and atrial fibrillation in long term. His bundle pacing (HBP) is a physiological alternative to RVP, and could overcome its drawbacks. Recent studies assessed the feasibility and safety of HBP in expert centers with a vast experience of this technique. These results may not apply to less experienced centers. We aim to evaluate the feasibility and safety of permanent HBP performed by physicians who are new to this technique. Methods We included all patients who underwent pacemaker implantation with attempt of HBP in three hospitals between September 2017 and January 2020. Indication for HBP was left to operators' discretion. All the operators were new for HBP. His bundle (HB) electrical parameters were recorded at implant, 3‐ and 12‐month follow‐up. Results HBP was successful in 141 of 170 patients (82.9%); selective HBP was obtained in 96 patients and nonselective HBP in 45. The mean procedure and fluoroscopy durations were 67.0 ± 28.8 min, and 7.3 ± 8.1 min (3.1 ± 4.1 Gy·cm 2 ), respectively. The mean HB paced QRS duration was 106 ± 18 ms. The mean HB capture threshold was 1.29 ± 0.77 V and did not increase at 3‐ and 12‐month follow‐up. The ventricular lead revision was required in five patients. Our results showed a rapid technical learning allowing a high procedure success rate (89.8%) after 15 procedures. Conclusion HBP performed by operators new to this technique appeared feasible and safe. This should encourage HBP to be performed in patients expected to experience high RVP burden.