Department of Cardiology, The Second Hospital Affiliated to ShaoXing University, 123 Yan'an Road, Shaoxing, 312000, Zhejiang Province, China.
Department of Ultrasound, The Second Hospital Affiliated to ShaoXing University, 123 Yan'an Road, Shaoxing, 312000, Zhejiang Province, China.
BMC Cardiovasc Disord. 2021 Feb 24;21(1):112. doi: 10.1186/s12872-020-01842-1.
HB pacing is a promising approach to achieve physiological pacing, but its efficacy and long-term effects require further validation. In current study, we deemed to investigate the effect of the His bundle pacing (HBP) lead location on pacing parameters.
2D echocardiography imaging was performed after successful implantation, according to which the patients were divided into groups A (whose His lead tips were at the atrial side) and B (whose His lead tips were at the ventricular side). The capture thresholds, sensing values, and H-V intervals between the two groups were compared.
Thirteen patients were in group A and 16 patients were in group B. The average capture thresholds during, 1 month, and 1 year after operation were 1.20 ± 0.34, 0.69 ± 0.29, and 0.92 ± 0.80 V/0.5 ms for group A and 1.14 ± 0.43, 0.81 ± 0.39, and 0.98 ± 0.59 V/0.5 ms for group B, respectively. The difference between the two groups was not significant. The threshold values in both groups decreased significantly in 1 month and slightly increased in 1 year. The sensing values of group A were 1.87 ± 0.82, 1.95 ± 0.76, and 1.88 ± 0.75 mV, while those of group B were 4.53 ± 1.37, 4.69 ± 1.38, and 4.59 ± 1.42 mV. The difference among the three time points was not significant. However, the sensing values in group A were consistently significantly lower than those in group B. The HV interval in group A was significantly longer than that in group B.
The implantation site of HBP leads has a significant effect on sensing values for that His leads crossing the tricuspid annulus toward the ventricle are associated with higher sensing values, compared to a more proximal location. Meanwhile, lead location has no evident effect on capture thresholds that is improved significantly shortly after operation.
希氏束起搏（HBP）是实现生理性起搏的一种很有前途的方法，但它的疗效和长期效果需要进一步验证。在本研究中，我们旨在探讨希氏束起搏导线位置对起搏参数的影响。
在成功植入后进行二维超声心动图检查，根据检查结果将患者分为 A 组（希氏束导线尖端位于心房侧）和 B 组（希氏束导线尖端位于心室侧）。比较两组的起搏阈值、感知值和 H-V 间期。
A 组 13 例，B 组 16 例。术后 1 个月和 1 年时，A 组的平均起搏阈值分别为 1.20±0.34、0.69±0.29 和 0.92±0.80V/0.5ms，B 组分别为 1.14±0.43、0.81±0.39 和 0.98±0.59V/0.5ms。两组间差异无统计学意义。两组阈值在术后 1 个月均显著下降，1 年后略有升高。A 组感知值分别为 1.87±0.82、1.95±0.76 和 1.88±0.75mV，B 组分别为 4.53±1.37、4.69±1.38 和 4.59±1.42mV。三个时间点之间的差异无统计学意义。然而，A 组的感知值始终明显低于 B 组。A 组的 HV 间期明显长于 B 组。
HBP 导线的植入部位对感知值有显著影响，因为希氏束导线穿过三尖瓣环向心室走行时，感知值较高，而位于更靠近近端的位置时，感知值较低。同时，导线位置对起搏阈值没有明显影响，术后即刻显著改善。
