Experimental His-bundle pacing: histopathological and electrophysiological examination

Pacing Clin Electrophysiol. 1999 Apr;22(4 Pt 1):562-6. doi: 10.1111/j.1540-8159.1999.tb00497.x.

Abstract

His-bundle pacing gives a more physiological ventricular contraction in comparison to right ventricular apical pacing. However the problems of lead fixation and stability of long-term His-bundle pacing are yet unsolved. We used six adult beagles, in which a screw-in lead was anchored in the His-bundle region for observation of the pacing conditions and histopathologic changes of the conduction system over the course of 2 months. In the results, a satisfactory fixation was obtained using a conventional screw-in lead and no histological influence on the conduction system was observed. The pacing threshold at the time of implantation was 1.15 +/- 0.69 V (3.23 +/- 3.08 mA) in the pulse width of 0.5 ms. R wave amplitude, the impedance and slew rate were 7.28 +/- 2.04 mV, 409 +/- 102 Ohm, and 0.65 +/- 0.41 V/s, respectively. Two months later, these parameters changed to 2.83 +/- 1.06 V (10.4 +/- 5.71 mA), 5.63 +/- 1.62 mV, 310 +/- 71.3 Ohm, and 0.49 +/- 0.22 V/s, respectively. These results suggest the feasibility of clinical application of permanent His-bundle pacing.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Bundle of His / pathology*
  • Bundle of His / physiopathology
  • Cardiac Pacing, Artificial / methods*
  • Dogs
  • Electric Impedance
  • Electrocardiography*
  • Electrodes, Implanted
  • Endocardium / pathology
  • Endocardium / physiopathology
  • Feasibility Studies
  • Follow-Up Studies
  • Myocardial Contraction / physiology
  • Pacemaker, Artificial
  • Tricuspid Valve / pathology
  • Tricuspid Valve / physiopathology
  • Ventricular Function / physiology