Intermediate-term performance and safety of His-bundle pacing leads: A single-center experience
The short-term safety, feasibility, and performance of His-bundle pacing (HBP) leads have been reported; however, their longer-term performance beyond 1 year remains unclear. The purpose of this study was to examine the intermediate-term performance and safety of HBP. All HBP lead implants at Virgin...
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| Veröffentlicht in: | Heart rhythm 2021-05, Vol.18 (5), p.743-749 |
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| creator | Teigeler, Todd Kolominsky, Jeffrey Vo, Chau Shepard, Richard K. Kalahasty, Gautham Kron, Jordana Huizar, Jose F. Kaszala, Karoly Tan, Alex Y. Koneru, Jayanthi N. Ellenbogen, Kenneth A. Padala, Santosh K. |
| description | The short-term safety, feasibility, and performance of His-bundle pacing (HBP) leads have been reported; however, their longer-term performance beyond 1 year remains unclear.
The purpose of this study was to examine the intermediate-term performance and safety of HBP.
All HBP lead implants at Virginia Commonwealth University between January 2014 and January 2019 were analyzed. HBP was performed using a Medtronic SelectSecure 3830-69 cm pacing lead.
Of 295 attempts, successful HBP implantation (selective or nonselective) was seen in 274 cases (93%). Mean follow-up duration was 22.8 ± 19.5 months (median 19.5; interquartile range 11–33). Mean age was 69 ± 15 years; 58% were males; and ejection fraction |
| doi_str_mv | 10.1016/j.hrthm.2020.12.031 |
| format | Article |
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The purpose of this study was to examine the intermediate-term performance and safety of HBP.
All HBP lead implants at Virginia Commonwealth University between January 2014 and January 2019 were analyzed. HBP was performed using a Medtronic SelectSecure 3830-69 cm pacing lead.
Of 295 attempts, successful HBP implantation (selective or nonselective) was seen in 274 cases (93%). Mean follow-up duration was 22.8 ± 19.5 months (median 19.5; interquartile range 11–33). Mean age was 69 ± 15 years; 58% were males; and ejection fraction <50% was noted in 30%. Indications for pacemaker included sick sinus syndrome in 41%, atrioventricular block in 36%, cardiac resynchronization therapy in 7%, and refractory atrial fibrillation in 15%. Selective HBP was achieved in 33%. Mean HBP capture threshold at implant was 1.1 ± 0.9 V at 0.8 ± 0.2 ms, which significantly increased at chronic follow-up to 1.7 ± 1.1 V at 0.8 ± 0.3 ms (P <.001). Threshold was ≥2.5 V in 24% of patients, and 28% had an increase in HBP threshold ≥1 V. Loss of His-bundle capture at follow-up (septal right ventricular pacing) was seen in 17%. There was a total of 31 (11%) lead revisions, primarily for unacceptably high thresholds.
Although HBP can prevent or improve pacing-induced cardiomyopathy, the elevated capture thresholds, loss of His-bundle capture, and lead revision rates at intermediate follow-up are of concern. Longer-term follow-up data from multiple centers are needed.
[Display omitted]</description><identifier>ISSN: 1547-5271</identifier><identifier>EISSN: 1556-3871</identifier><identifier>DOI: 10.1016/j.hrthm.2020.12.031</identifier><identifier>PMID: 33418127</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Atrioventricular Block - physiopathology ; Atrioventricular Block - therapy ; Bundle of His - physiopathology ; Capture threshold ; Cardiac Pacing, Artificial - methods ; Cardiac resynchronization ; Electrocardiography ; Feasibility Studies ; Female ; Follow-Up Studies ; Heart Rate - physiology ; His-bundle pacing ; Humans ; Lead revision ; Male ; Physiological pacing ; Retrospective Studies ; Treatment Outcome ; Ventricular Function, Left - physiology</subject><ispartof>Heart rhythm, 2021-05, Vol.18 (5), p.743-749</ispartof><rights>2021 Heart Rhythm Society</rights><rights>Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-f671ec6cedf3ee048409ed9ffbbbda40e03f2d9206358409f141b5fec719320f3</citedby><cites>FETCH-LOGICAL-c425t-f671ec6cedf3ee048409ed9ffbbbda40e03f2d9206358409f141b5fec719320f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.hrthm.2020.12.031$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33418127$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Teigeler, Todd</creatorcontrib><creatorcontrib>Kolominsky, Jeffrey</creatorcontrib><creatorcontrib>Vo, Chau</creatorcontrib><creatorcontrib>Shepard, Richard K.</creatorcontrib><creatorcontrib>Kalahasty, Gautham</creatorcontrib><creatorcontrib>Kron, Jordana</creatorcontrib><creatorcontrib>Huizar, Jose F.</creatorcontrib><creatorcontrib>Kaszala, Karoly</creatorcontrib><creatorcontrib>Tan, Alex Y.</creatorcontrib><creatorcontrib>Koneru, Jayanthi N.</creatorcontrib><creatorcontrib>Ellenbogen, Kenneth A.</creatorcontrib><creatorcontrib>Padala, Santosh K.</creatorcontrib><title>Intermediate-term performance and safety of His-bundle pacing leads: A single-center experience</title><title>Heart rhythm</title><addtitle>Heart Rhythm</addtitle><description>The short-term safety, feasibility, and performance of His-bundle pacing (HBP) leads have been reported; however, their longer-term performance beyond 1 year remains unclear.
The purpose of this study was to examine the intermediate-term performance and safety of HBP.
All HBP lead implants at Virginia Commonwealth University between January 2014 and January 2019 were analyzed. HBP was performed using a Medtronic SelectSecure 3830-69 cm pacing lead.
Of 295 attempts, successful HBP implantation (selective or nonselective) was seen in 274 cases (93%). Mean follow-up duration was 22.8 ± 19.5 months (median 19.5; interquartile range 11–33). Mean age was 69 ± 15 years; 58% were males; and ejection fraction <50% was noted in 30%. Indications for pacemaker included sick sinus syndrome in 41%, atrioventricular block in 36%, cardiac resynchronization therapy in 7%, and refractory atrial fibrillation in 15%. Selective HBP was achieved in 33%. Mean HBP capture threshold at implant was 1.1 ± 0.9 V at 0.8 ± 0.2 ms, which significantly increased at chronic follow-up to 1.7 ± 1.1 V at 0.8 ± 0.3 ms (P <.001). Threshold was ≥2.5 V in 24% of patients, and 28% had an increase in HBP threshold ≥1 V. Loss of His-bundle capture at follow-up (septal right ventricular pacing) was seen in 17%. There was a total of 31 (11%) lead revisions, primarily for unacceptably high thresholds.
Although HBP can prevent or improve pacing-induced cardiomyopathy, the elevated capture thresholds, loss of His-bundle capture, and lead revision rates at intermediate follow-up are of concern. Longer-term follow-up data from multiple centers are needed.
[Display omitted]</description><subject>Aged</subject><subject>Atrioventricular Block - physiopathology</subject><subject>Atrioventricular Block - therapy</subject><subject>Bundle of His - physiopathology</subject><subject>Capture threshold</subject><subject>Cardiac Pacing, Artificial - methods</subject><subject>Cardiac resynchronization</subject><subject>Electrocardiography</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Rate - physiology</subject><subject>His-bundle pacing</subject><subject>Humans</subject><subject>Lead revision</subject><subject>Male</subject><subject>Physiological pacing</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Ventricular Function, Left - physiology</subject><issn>1547-5271</issn><issn>1556-3871</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKAzEUhoMotlafQJAs3UzNbW6Ci1LUCgU3ug6Z5MSmzKUmU7Fvb6atLl2d23_-w_kQuqZkSgnN7tbTle9XzZQRFjtsSjg9QWOaplnCi5yeDrnIk5TldIQuQlgTwsqM8HM04lzQgrJ8jORL24NvwDjVQzKkeAPedr5RrQasWoODstDvcGfxwoWk2ramBrxR2rUfuAZlwj2e4RCrGhINgx2G72jiIDpcojOr6gBXxzhB70-Pb_NFsnx9fpnPlokWLO0Tm-UUdKbBWA5ARCFICaa0tqoqowQBwi0zJSMZT4eZpYJWqQWd05IzYvkE3R58N7773ELoZeOChrpWLXTbIJnIszRLi0JEKT9Ite9C8GDlxrtG-Z2kRA5k5VruycqBrKRMRrJx6-Z4YFtFXH87vyij4OEggPjmlwMvg94jMM6D7qXp3L8HfgAVzovv</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Teigeler, Todd</creator><creator>Kolominsky, Jeffrey</creator><creator>Vo, Chau</creator><creator>Shepard, Richard K.</creator><creator>Kalahasty, Gautham</creator><creator>Kron, Jordana</creator><creator>Huizar, Jose F.</creator><creator>Kaszala, Karoly</creator><creator>Tan, Alex Y.</creator><creator>Koneru, Jayanthi N.</creator><creator>Ellenbogen, Kenneth A.</creator><creator>Padala, Santosh K.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202105</creationdate><title>Intermediate-term performance and safety of His-bundle pacing leads: A single-center experience</title><author>Teigeler, Todd ; Kolominsky, Jeffrey ; Vo, Chau ; Shepard, Richard K. ; Kalahasty, Gautham ; Kron, Jordana ; Huizar, Jose F. ; Kaszala, Karoly ; Tan, Alex Y. ; Koneru, Jayanthi N. ; Ellenbogen, Kenneth A. ; Padala, Santosh K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-f671ec6cedf3ee048409ed9ffbbbda40e03f2d9206358409f141b5fec719320f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Atrioventricular Block - physiopathology</topic><topic>Atrioventricular Block - therapy</topic><topic>Bundle of His - physiopathology</topic><topic>Capture threshold</topic><topic>Cardiac Pacing, Artificial - methods</topic><topic>Cardiac resynchronization</topic><topic>Electrocardiography</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Rate - physiology</topic><topic>His-bundle pacing</topic><topic>Humans</topic><topic>Lead revision</topic><topic>Male</topic><topic>Physiological pacing</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Ventricular Function, Left - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Teigeler, Todd</creatorcontrib><creatorcontrib>Kolominsky, Jeffrey</creatorcontrib><creatorcontrib>Vo, Chau</creatorcontrib><creatorcontrib>Shepard, Richard K.</creatorcontrib><creatorcontrib>Kalahasty, Gautham</creatorcontrib><creatorcontrib>Kron, Jordana</creatorcontrib><creatorcontrib>Huizar, Jose F.</creatorcontrib><creatorcontrib>Kaszala, Karoly</creatorcontrib><creatorcontrib>Tan, Alex Y.</creatorcontrib><creatorcontrib>Koneru, Jayanthi N.</creatorcontrib><creatorcontrib>Ellenbogen, Kenneth A.</creatorcontrib><creatorcontrib>Padala, Santosh K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Heart rhythm</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Teigeler, Todd</au><au>Kolominsky, Jeffrey</au><au>Vo, Chau</au><au>Shepard, Richard K.</au><au>Kalahasty, Gautham</au><au>Kron, Jordana</au><au>Huizar, Jose F.</au><au>Kaszala, Karoly</au><au>Tan, Alex Y.</au><au>Koneru, Jayanthi N.</au><au>Ellenbogen, Kenneth A.</au><au>Padala, Santosh K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intermediate-term performance and safety of His-bundle pacing leads: A single-center experience</atitle><jtitle>Heart rhythm</jtitle><addtitle>Heart Rhythm</addtitle><date>2021-05</date><risdate>2021</risdate><volume>18</volume><issue>5</issue><spage>743</spage><epage>749</epage><pages>743-749</pages><issn>1547-5271</issn><eissn>1556-3871</eissn><abstract>The short-term safety, feasibility, and performance of His-bundle pacing (HBP) leads have been reported; however, their longer-term performance beyond 1 year remains unclear.
The purpose of this study was to examine the intermediate-term performance and safety of HBP.
All HBP lead implants at Virginia Commonwealth University between January 2014 and January 2019 were analyzed. HBP was performed using a Medtronic SelectSecure 3830-69 cm pacing lead.
Of 295 attempts, successful HBP implantation (selective or nonselective) was seen in 274 cases (93%). Mean follow-up duration was 22.8 ± 19.5 months (median 19.5; interquartile range 11–33). Mean age was 69 ± 15 years; 58% were males; and ejection fraction <50% was noted in 30%. Indications for pacemaker included sick sinus syndrome in 41%, atrioventricular block in 36%, cardiac resynchronization therapy in 7%, and refractory atrial fibrillation in 15%. Selective HBP was achieved in 33%. Mean HBP capture threshold at implant was 1.1 ± 0.9 V at 0.8 ± 0.2 ms, which significantly increased at chronic follow-up to 1.7 ± 1.1 V at 0.8 ± 0.3 ms (P <.001). Threshold was ≥2.5 V in 24% of patients, and 28% had an increase in HBP threshold ≥1 V. Loss of His-bundle capture at follow-up (septal right ventricular pacing) was seen in 17%. There was a total of 31 (11%) lead revisions, primarily for unacceptably high thresholds.
Although HBP can prevent or improve pacing-induced cardiomyopathy, the elevated capture thresholds, loss of His-bundle capture, and lead revision rates at intermediate follow-up are of concern. Longer-term follow-up data from multiple centers are needed.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33418127</pmid><doi>10.1016/j.hrthm.2020.12.031</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Atrioventricular Block - physiopathology Atrioventricular Block - therapy Bundle of His - physiopathology Capture threshold Cardiac Pacing, Artificial - methods Cardiac resynchronization Electrocardiography Feasibility Studies Female Follow-Up Studies Heart Rate - physiology His-bundle pacing Humans Lead revision Male Physiological pacing Retrospective Studies Treatment Outcome Ventricular Function, Left - physiology |
| title | Intermediate-term performance and safety of His-bundle pacing leads: A single-center experience |
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