FIRST EXPERIENCE OF DIRECT CONSTANT HIS BUNDLE PACING

Abstract

Objective: to study electrophysiological parameters and clinical results of direct constant His bundle pacing (HBP). Materials and methods: we examined 36 patients, divided into 2 equal groups (of 18 patients) according to the type of pacing. Group 1 included patients with atrial lead delivery and group 2with ventricle lead delivery. Within 12 months after implantation of the pacemaker were evaluated pacing options, ECG data, changes in heart cavities sizes, quality of life assessments with the MOS SF-36. Results: it turned out that in group 1 QRS duration was 111±13 ms, whereas QRS duration in group 2 was 134±19 ms. So QRS duration and morphology corresponded to physiological and excluded uprising of ventricle dyssynchrony, LV diastolic dysfunction and chronic heart insufficiency, quality of life were higher for group 1 paients : 71±8,5 whereas 63±9,9 in group 2. Conclusions: implantation atrial lead in His-bundle provides more reliable fixation, less early dislocation risk in early postoperative period and facilitates lead extraction. Clinical implementation of this method will contribute Russian industry, which is especially important in import substitution conditions, to the creation of special lead, delivery system and DDDR pacemaker with a backup ventricle channel.