In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to EHRA Ivory (& above) Members, Fellows of the ESC and Young combined Members

His Bundle Pacing plus LV lead in heart failure patients candidate to CRT

Session Rapid Fire 5: improving the response to cardiac resynchronization therapy: emerging technologies

Speaker Lina Marcantoni

Congress : EHRA 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Cardiac Resynchronization Therapy
  • Session type : Rapid Fire Abstracts
  • FP Number : 927

Authors : L Marcantoni (Rovigo,IT), M Zuin (Rovigo,IT), G Pastore (Rovigo,IT), E Baracca (Rovigo,IT), C Picariello (Rovigo,IT), S Aggio (Rovigo,IT), S Giatti (Rovigo,IT), A Maddalozzo (Rovigo,IT), K D'elia (Rovigo,IT), M Carraro (Rovigo,IT), D Lanza (Rovigo,IT), P Galasso (Rovigo,IT), L Roncon (Rovigo,IT), F Zanon (Rovigo,IT)


L Marcantoni1 , M Zuin2 , G Pastore3 , E Baracca3 , C Picariello2 , S Aggio2 , S Giatti2 , A Maddalozzo2 , K D'elia2 , M Carraro2 , D Lanza2 , P Galasso2 , L Roncon2 , F Zanon3 , 1General Hospital of Rovigo, electrophysiology - Rovigo - Italy , 2General Hospital of Rovigo, Cardiology - Rovigo - Italy , 3General Hospital of Rovigo, Electrophysiology - Rovigo - Italy ,


Introduction: His-bundle pacing (HBP) can recruit latent His-Purkinje tissue in BBB patients resulting in QRS narrowing/normalization thus shortening the LV electrical delay. Pacing from LV can complete this delay's reduction. Recently HBP has been evaluated as an alternative of CRT with positive results.

Objective:The purpose of this study was to assess the clinical, echo and QRS response to permanent HBP added to standard LV pacing in CRT-indicated patients.

Methods: we rectrospectively analyzed 27 patients (mean age 76±7 years; 19 males) with standard indication for cardiac resynchronization therapy. Basal mean QRS duration was 155±29 ms, basal mean EF 30±5% and basal mean NYHA class 2.8±0.5. AV-block was present in 7 (26%) patients. All patients received the lead in the hisian area (15 S-HBP and 12 NS-HBP) and the LV lead via coronary sinus (0 MPP). 14 patients (52%) had ischemic cardiopathy; 22 patients (81%) had hypertension, 13 patients (48%) had diabetes and 5 (18%) patients had severe kidney disease. A CRT-D device with coil in the RV apex or septum was implanted in 4 patients; in these cases HB lead was plugged into the atrial port. The remaining patients received CRT-P devices with HB lead plugged in the RV port. We set V-V interval to 0 ms. 

Results: All the patients were checked yearly with in-clinic visit and echo. Mean follow-up was 4.2±2.8 years. At the end of follow up mean QRS duration was 131.4±22 ms (P 0.03); mean EF 39±10% (P 0.003).  9 (33%) patients were classified as "super-responders"with final EF =45%. In two cases EF decreased. Median VP was >99%. 11 patients showed an high burden of AT/AF (>50%). The mean longevity of the devices was 4.1±1.5 years. During the first year of follow-up 4 patients (15%) patients experienced heart failure episodes.

Conclusion: HBP associated to LV pacing in HF patients showed a positive effect in cardiac remodelling. 71% patients resulted "responders"and 33% "super-responders"with a final EF=45%. QRS duration and clinical outcomes significantly improved.

Based on your interests

Three reasons why you should become a member

Become a member now
  • 1Access your congress resources all year-round on the New ESC 365
  • 2Get a discount on your next congress registration
  • 3Continue your professional development with free access to educational tools
Become a member now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim, Bristol-Myers Squibb and Pfizer Alliance, and Novartis Pharma AG. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are