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Acta Cardiologica
ISSN: 0001-5385 (Print) 0373-7934 (Online) Journal homepage:
http://www.tandfonline.com/loi/tacd20
His-bundle pacing using dual-chambercardioverter–defibrillator
in patients with chronicatrial fibrillation: different pacing and
sensingfeatures
Agnieszka Sławuta, Dariusz Biały, Dorota Zyśko, Grzegorz Mazur
& JacekGajek
To cite this article: Agnieszka Sławuta, Dariusz Biały, Dorota
Zyśko, Grzegorz Mazur & JacekGajek (2017) His-bundle pacing
using dual-chamber cardioverter–defibrillator in patients
withchronic atrial fibrillation: different pacing and sensing
features, Acta Cardiologica, 72:3, 343-344,DOI:
10.1080/00015385.2017.1305169
To link to this article:
https://doi.org/10.1080/00015385.2017.1305169
Published online: 31 Mar 2017.
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343ACTA CARDIOLOGICA 2017; 72(3): 343–344
Address for correspondence:
Jacek Gajek, M.D., Ph.D.,Dept. of Cardiology, Wroclaw Medical
University, Borowska 213, 50-556 Wrocław, Poland.E-mail:
[email protected]
Received 13 March 2016; revision accepted for publication 18
April 2016.
A direct His-bundle pacing wins popularity as more implantation
centres use this technique. Maintaining physiologic ventricular
activation (in patients with nar-row QRS complex) or even
correcting the LBBB (in patients with pre-existing LBBB), are of
particular importance. The most interesting population are
indi-viduals with chronic atrial fibrillation. If there is no need
for atrial pacing/sensing, standard dual-chamber devices can be
used. This reduces procedure costs and ensures ventricular pacing
in case of improper or high threshold His-bundle pacing. In
patients with severe left ventricu-lar systolic dysfunction this
way of using the dual-cham-ber ICD can be a solution for all the
issues.
We present two cases of patients with chronic, slow atrial
fibrillation requiring pacing, left ventricular systolic
dysfunction and/or ventricular arrhythmia. The ICD was implanted
using the atrial channel for His-bundle pacing/sensing. The ICD
electrode was placed in the right ven-tricle apex for back-up
pacing and arrhythmia detection and treatment. These two cases
differ in terms of His-
His-bundle pacing using dual-chamber cardioverter- defibrillator
in patients with chronic atrial fibrillation: different pacing and
sensing features
Agnieszka SŁAWUTA1, MD, PhD; Dariusz BIAŁY2, MD, PhD; Dorota
ZYŚKO3, MD, PhD; Grzegorz MAZUR4, MD, PhD; Jacek GAJEK2, MD,
PhD1Department of Cardiology, Klodzko County Hospital, Kłodzko,
Poland; 2Department of Cardiology, Wroclaw Medical University,
Wrocław, Poland; 3Department of Emergency Medicine, Wroclaw Medical
University, Wrocław, Poland; 4Department of Internal and
Occupational Medicine and Hypertension, Wroclaw Medical University,
Wrocław, Poland.
Keywords Direct His-bundle pacing – atrial fibrillation.
bundle pacing and sensing features in the atrial channel which
is depicted in the figure. In the upper panel the direct
His-bundle pacing occurs to be selective, detected by the device as
AP/VS but the sensing of the visible His-bundle potential is not
possible, so the spontaneous QRS complex is recognized as PVC. In
the lower panel the pacing is not selective, nevertheless detected
by the device as AP/VS, and the sensing of the His-bundle potential
and subsequent QRS complex are recognized as AS/VS.
CONCLUSION
As the implantation of dual-chamber ICDs for His-bundle
pacing/sensing in patients with atrial fibrillation may spread in
the near future, understanding of these atypical electrocardiograms
is of a paramount importance.
CONFLICT OF INTEREST: none.
http://dx.doi.org/10.1080/00015385.2017.1305169© 2017 Belgian
Society of Cardiology
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