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Autopsy evaluation of the implantation site of a His bundle pacing lead demonstrating selective capture
Author(s) -
Kato Hiroyuki,
Igawa Osamu,
Suga Kazumasa,
Murakami Hisashi,
Kada Kenji,
Tsuboi Naoya,
Yanagisawa Satoshi,
Inden Yasuya,
Murohara Toyoaki
Publication year - 2020
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13989
Subject(s) - medicine , cardiology , autopsy , qrs complex , ventricular pacing , electrical conduction system of the heart , heart block , left bundle branch block , bundle , cardiac resynchronization therapy , atrioventricular block , commissure , heart failure , electrocardiography , anatomy , ejection fraction , materials science , composite material
Evaluations of His bundle pacing (HBP) lead location at autopsy examination have been rarely reported. We report an autopsy case of a 98‐year‐old man who underwent HBP implantation due to atrioventricular block and heart failure. Although selective HBP was achieved with an acceptable threshold, the stimulus‐to‐QRS interval was relatively longer without correction of the right bundle‐branch block. A macroscopic examination revealed that the HBP lead was inserted on the ventricular side passing through the anteroseptal commissure of the tricuspid valve. Transthyretin cardiac amyloidosis may affect the distal conduction system resulting in a long stimulus‐to‐QRS interval during selective HBP.