HIS Bundle Pacing procedure, a newer technology in permanent pacemaker implantation for Bradyarrhythmias.
About the Patient and condition
A 58-year-old diabetic gentleman presented with repeated episodes of syncope and easy fatiguability, for the past few weeks.
On evaluation, ECG showed complete heart block with narrow QRS complex escape rhythm and ECHO showed normal LV function. Coronary Angiogram was normal. He was recommended to undergo permanent pacemaker implantation with the new technology, HIS bundle pacing. This technique would help avoid long term deleterious effect of RV apical Pacing. HIS Bundle Pacing procedure was performed under local anaesthesia and through left subclavian vein access, special screw-in lead was fixed in the HIS Bundle region and HIS Bundle capture was confirmed by using an electrophysiology recording system and 12 lead electrocardiogram (to analyse pacing morphologies). Selective HIS capture was obtained at lower output [up to 0.5V @ 1.0ms] with narrow I II QRS morphology similar to native QRS.
HIS bundle pacing is an innovative approach, in which the permanent pacemaker leads are placed at the HIS bundle, instead of placing them in the right ventricle. The traditional approach of placing the leads in the right ventricle causes contraction of the right ventricle before the left ventricle which is known as dyssynchrony. This reduces cardiac efficiency and hence, in long-term, such patients may suffer from atrial fibrillation, cardiomyopathy or a heart failure. HIS Bundle Pacing offers a superior ventricular synchronous pacing strategy and better outcomes with respect to LV end diastolic and end systolic diameters and systolic function, shorter interventricular electromechanical delay, improvement in quality of life, reduction in NYHA class, and improvement in 6-min walk when compared with traditional RV Pacing. HIS bundle pacing is steadily gaining its importance in cardiac science.
Expertise at Apollo Hospitals
Apollo Hospitals, Chennai has introduced HIS Bundle Pacing procedure to treat bradyarrhythmias, as an alternative approach to RV pacing which increases risk of atrial fibrillation, heart failure and mortality. The Cardiology department at Apollo Hospitals is among the most experienced and our Cardiologists and Electrophysiologists are highly skilled to perform HIS bundle pacing. Apollo Hospitals is known to introduce the latest technologies in India like the advanced Aquilion One Prism 640-slice CT Scanner for non-invasive cardiac assessments.
Apollo Hospitals – Touching Lives
Apollo Hospitals has always been a pioneer in introducing newer technology that improves long term outcomes and quality of life of patients. We had also organized a workshop to train doctors for using this new technique. An exclusive symposium on Physiological Pacing was also organized to create awareness among the physicians about this innovative approach.
Patient and his family expressed their gratitude and happiness to the doctors, nurses and entire staff of Apollo Hospitals.