Allied Professionals (Non-physician submissions only) -> Clinical Research D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-046 - A Prospective Study On His Bundle Pacing And Right Ventricular Function (ID 896)


Background: Previous studies has shown long-term right ventricular (RV) pacing has significant deleterious effects on tricuspid valve function with significant increases in tricuspid regurgitation (TR) (10-39%). His Bundle pacing (HBP) has been shown to be physiologically superior to RV pacing.
Objective: To evaluate right ventricular function using transthoracic echocardiography (TTE) in patients who underwent HBP at baseline and at 12 months follow up.
Methods: Sixty-six patients (males = 43; age 67±13 years; sinus node disease = 37, atrioventricular block = 22; congestive heart failure = 7) presented for HBP. Patients underwent TTE pre-implant and 12 months post-implantation. The TTEs were assessed for severity of TR, RV size and systolic function, left atrial (LA) volume and left ventricular diastolic function.
Results: HBP was acutely successful in all cases with a mean follow-up time of 405 days and mean ventricular pacing percentage after 12 months was 42±36% (range 11%-98%). At baseline, 78% of patients had no TR, 15% had mild TR, 5% had moderate TR and 2% had severe TR. These numbers remained unchanged after 12 months. There was also no significant change in RV size and function and no decline in left ventricular diastolic function (table 1).
Conclusion: HBP has not resulted in any deterioration in TR or RV functions. This could be due to the less chances of mechanical interference of these leads on the tricuspid valve apparatus compared to the conventional leads. Thus, an alternative pacing site such as the His bundle can be utilised to avoid worsening of TR.
Table 1
Baseline12 Months
RV basal (mm)41 ± 641 ± 7
RV mid (mm)36 ± 834 ± 8
RV long. (mm)75 ± 1085 ± 1
TAPSE (mm)24 ± 524 ± 6
RV S’ (mm)13 ± 312 ± 3
LA volume (ml/m2)38 ± 1337 ± 12
E/A ratio1.2 ± 0.81 ± 0.5
Mitral Valve Decel. Time (ms)222 ± 79202 ± 70