Nonselective His Bundle pacing with a biphasic waveform. Enhancing septal resynchronization

EMILIO LOGARZO; MARIA P BONOMINI; LUIS DANTE BARJA; ANALIA PAOLUCCI; DANIEL FELIPE ORTEGA; NICOLAS MANGANI

EUROPACE

OXFORD UNIV PRESS

Lugar: Oxford; Año: 2017 vol. 0 p. 1 - 7

1099-5129

Aims. His bundle pacing has shown to prevent detrimental effects from right ventricular apical pacing (RVA) and proved to resynchronize many conduction disturbances cases. However, the extent of His bundle pacing resynchronization is limited. An optimized stimulation waveform could expand this limit when implemented in His bundle pacing sets. In this work, we temporarily implemented RVA and Nonselective His Bundle pacing with a biphasic anodal-first waveform (AF-nHB) and compared their effects against sinus rhythm (SR). Methods. Fifteen patients referred for electrophysiologic study with conduction disturbances, cardiomyopathy and ejection fraction below 35% were enrolled for the study. The following acute parameters were measured: QRS duration, left ventricular activation (RLVT), time of isovolumic contraction (IVCT), ejection fraction (EF), and dP/dtmax. Results. QRS duration and RLVT decreased markedly under AF-nHB (SR: 169±34 ms. vs nHB: 116±31 ms, p