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Impact of His bundle pacing versus right ventricle pacing on right ventricular performance in patients undergoing permanent pacemaker implantation
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  • Domenico Grieco,
  • Edoardo Bressi,
  • Karol Curila,
  • Santosh Padala,
  • Kamil Sedlacek,
  • Jordana Kron,
  • Elisa Fedele,
  • Ermenegildo de Ruvo,
  • Kenneth Ellenbogen,
  • Leonardo Calò,
  • Oana Ionita,
  • Sara Giannuzzi,
  • Alessandro Fagagnini,
  • Jessica Formichetti,
  • Luca Sangiovanni,
  • Monia Minati,
  • Germana Panattoni
Domenico Grieco
Policlinico Casilino of Rome
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Edoardo Bressi
Policlinico Casilino
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Karol Curila
, Charles University and University Hospital Kralovske Vinohrady
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Santosh Padala
Virginia Commonwealth University, Medical College of Virginia hospitals
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Kamil Sedlacek
University Hospital Hradec Kralove
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Jordana Kron
Virginia commonwealth University
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Elisa Fedele
Policlinico Casilino
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Ermenegildo de Ruvo
Policlinico Casilino, ASL RM/B
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Kenneth Ellenbogen
Virginia Commonwealth University
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Leonardo Calò
Policlinico Casilino
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Oana Ionita
, Charles University and University Hospital Kralovske Vinohrady
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Sara Giannuzzi
Policlinico Casilino
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Alessandro Fagagnini
Policlinico Casilino
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Jessica Formichetti
Policlinico Casilino
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Luca Sangiovanni
Policlinico Casilino
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Monia Minati
Policlinico Casilino, ASL Roma B
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Germana Panattoni
Policlinico Casilino
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Abstract

Introduction. His Bundle pacing (HBP) is an emerging pacing technique that reproduces a more physiological ventricular synchronization than right ventricle pacing (RVP). However, its effects on the right ventricle (RV) performance are still unknown. Methods. In this observational study, we enrolled 84 patients (mean age 75.1±7.9 years, 64% male) with indication for pacemaker implantation to compare the effects of HBP versus RVP on RV performance. 42 patients (50%) underwent successful HBP and 42 patients (50%) apical RVP. Patients were evaluated both at baseline and after six months by transthoracic echocardiogram. Results. At six months follow up, we found a significant improvement in RV-GLS (baseline: HBP -17.2±4.7 vs. RVP -16.1±3.7 to 6-months: HBP -19.5±4.2 vs. RVP -13.6±2.9, p=<0.0001) and RV-FAC (baseline: HBP 33.8±3.9% vs. RVP 33.3±5.3% to 6-months: HBP 36.2±3.7% vs. RVP 30.9±5.1 %, p=<0.0001) with HBP whereas RVP was associated with a significant decline in both parameters. Moreover, RVP was associated with a significant worsening of TAPSE (baseline: HBP 20.2±4.1 mm vs. RVP 21.2±4.3 mm to 6-months: HBP 20.3±3.8 mm vs. RVP 18.5±3.5 mm, p=0.014) and tricuspid S wave velocity (baseline: HBP 11.2±2.9 cm/sec vs. RVP 11.8±2.3 cm/sec to 6-months: HBP 11.3±2.2 cm/sec vs. RVP 10.3±1.9 mm, p <0.0001) compared to HBP. Conversely from RVP, HBP significantly improved PASP (baseline: HBP 36.7±7.3 mmHg vs. RVP 34.6±6.1 mmHg to 6-months: HBP 32.4±5.9 mmHg vs. RVP 38.7±5.6 mmHg, p<0.0001) and tricuspid regurgitation (p=0.005) at six-months. Conclusions. HBP ensues a beneficial and protective impact on RV performance compared with RVP.

Peer review status:UNDER REVIEW

06 Sep 2020Submitted to Journal of Cardiovascular Electrophysiology
08 Sep 2020Assigned to Editor
08 Sep 2020Submission Checks Completed
09 Sep 2020Reviewer(s) Assigned