Cardiovascular Implantable Electronic Devices -> Leads & Electrodes: -> Implantation D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-226 - Electrocardiographic Morphology During Follow-up In Patients With His Bundle Pacing: A Single Center Study (ID 151)


Background: Successful His bundle pacing (HBP) is defined as achievement of selective or nonselective His bundle capture. However, there are limited data on the long-term pacing morphology on ECGs post successful implantation of HBP.
Objective: To evaluate the pacing morphology at implantation and at follow-up visits in HBP leads.
Methods: Consecutive HBP leads implanted at VCU from 01-2014 to 01-2019 were analyzed. Patients who had ECGs recorded during follow-up visits formed the study cohort. The primary endpoint was a change in pacing morphology at follow-up visits comparing to at implantation. Loss of HB capture was diagnosed when there was a notch/slur/plateau in lead I, V4-V6 or when V6 R wave peak time was >110 ms based on published criteria.
Results: Follow up ECGs were available for 194 patients with successful HBP implantation. At implantation, the selective and nonselective HBP morphology was noted on 39% and 61% of the ECGs. After a mean follow-up of 1.4 ± 1.3 years (median 1 year), selective HBP, nonselective HBP, and septal/right ventricular pacing morphology was noted on 30%, 54%, and 16% of the ECGs respectively. The overall mean QRSd was not different between first paced ECG and latest paced ECG (122 ± 25 ms vs. 122 ± 28 ms).
Conclusion: Despite successful His bundle capture (selective or non-selective) on ECGs at implantation, a significant proportion of patients had loss of His bundle capture at subsequent follow-up visits. Patients with HBP leads should get routine ECGs to document the presence or absence of His bundle capture.