Cardiovascular Implantable Electronic Devices -> Tachycardia Devices: -> Clinical Trials D-AB06 - Cardiac Resynchronization - LV and His Bundle Pacing! (ID 25) Abstract

D-AB06-02 - His-bundle Pacing In CHF-patients With Narrow QRS And Chronic AF By Dual-chamber Icd (ID 773)


Background: The regularization of the heart rate is essential for appropriate treatment of patients with congestive heart failure and atrial fibrillation. The standard cardiac resynchronization can be used, but in patients with initially narrow QRS this procedure is of no use.
Objective: The aim of our study is to assess the influence of direct His-bundle pacing in patients with congestive heart failure and chronic atrial fibrillation on clinical and echocardiographic parameters. The dual chamber ICD is used with atrial channel for His-bundle pacing.
Methods: The study population included 87 patients with CHF and chronic AF: group A - 65 pts treated with direct His-bundle pacing and group B - 22 patients implanted with single chamber ICD. The patients in group B constituting clinical controls with established clinical status and pharmacotherapy.
Results: The demographic data, clinical characteristics and echocardiography measurements at baseline and during follow-up were presented in the table:
During 12-months of follow-up the mean values of NYHA functional class, EF and LV dimensions did not change in group B but significantly improved in group A. The physiological His-bundle based pacing enabled optimal beta-blocker dosing.
Conclusion: His-bundle-based pacing in CHF-chronic AF patients contributed to significant echocardiographic and clinical improvement. Standard single-chamber ICD implantation in CHF-chronic AF patients yielded only SCD prevention not influencing the remodeling process. The CHF-patients with narrow QRS and chronic AF benefit from substantially higher beta-blockade which can be instituted in His-bundle pacing group.