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Value of surface electrocardiography in His bundle pacing

Bedeutung des Oberflächenelektrokardiogramms im Rahmen der His-Bündel-Stimulation

Abstract

His bundle pacing (HBP) provides physiological ventricular activation and is frequently used to treat patients with bradyarrhythmias. HBP reduces the risk of developing heart failure and atrial fibrillation by preventing ventricular electromechanical dyssynchrony associated with conventional right ventricular pacing. There are two types of HBP, including selective (S-HBP) and non-selective HBP (NS-HBP). It is important to determine the type of HBP during implantation and follow-up. This review discusses the role of standard surface electrocardiography in differentiating S‑HBP and NS-HBP and diagnosing loss of His bundle capture.

Zusammenfassung

Die His-Bündel-Stimulation (HBS) ermöglicht eine physiologische Ventrikelaktivierung und wird häufig bei Bradykardien eingesetzt. Die HBS senkt das Risiko der Entwicklung von Herzinsuffizienz und Vorhofflimmern durch Verhinderung einer ventrikulären elektromechanischen Dyssynchronie, die mit der üblichen rechtsventrikulären Stimulation assoziiert ist. Es gibt zwei Formen der HBS: die selektive (S-HBS) und die nichtselektive (NS-HBS). Wichtig ist die Bestimmung der HBS-Form bei Implantation und in der Nachverfolgung. In der vorliegenden Übersichtsarbeit wird die Rolle des Standardoberflächenelektrokardiogramms in der Unterscheidung zwischen S‑HBS und NS-HBS sowie in der Diagnostik eines Verlusts der His-Bündel-Erfassung erörtert.

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Correspondence to Adrian Baranchuk MD FACC FRCPC FCCS.

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Conflict of interest

G. Çinier, G. Bazoukis, B. Alexander, C.W. Israel and A. Baranchuk declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case. For images or other information within the manuscript which identify patients, consent was obtained from them and/or their legal guardians.

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Çinier, G., Bazoukis, G., Alexander, B. et al. Value of surface electrocardiography in His bundle pacing. Herzschr Elektrophys 31, 144–150 (2020). https://doi.org/10.1007/s00399-020-00678-8

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Keywords

  • Bradyarrhythmias
  • Ventricular activation
  • Ventricular electromechanical dyssynchrony
  • Atrial fibrillation
  • Heart failure

Schlüsselwörter

  • Bradykardie
  • Ventrikelaktivierung
  • Ventrikuläre elektromechanische Dyssynchronie
  • Vorhofflimmern
  • Herzinsuffizienz