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Abstract Introduction This case report highlights the novel role of His-bundle pacing (HBP) from right atrium, not just for preserving cardiacfunction, but also for avoiding interference with TriClip devices. Postprocedure, frequent significant sinus pauses required a pacemaker. HBP was chosen to avoid lead complications.
Written by Willy Frick A man in his 70s with a history of HFrEF and sick sinus syndrome s/p dual chamber pacemaker placement was admitted for overnight observation following outpatient placement of a mitral valve clip. This is unambiguous evidence of pacemaker malfunction. Imagine the pacemaker is set at a minimum rate of 60.
The team of investigators built a dataset of 1,032,975 cardiac ultrasound videos and corresponding expert interpretations to develop EchoCLIP. Key takeaways from the study include: EchoCLIP displayed strong performance when assessing cardiacfunction using heart images.
Methods This prospective observational study included patients with complete left bundle branch block (CLBBB) and cardiac resynchronization therapy (CRT) indication, as well as patients with QRSd<120ms and pacemaker indication. LBBP significantly improved cardiacfunction at 1week of follow-up.
Cardiac resynchronization therapy (CRT) exists as an option for patients with heart failure with reduced ejection fraction (HFrEF), for whom pharmacotherapy alone is insufficient to reduce symptoms and control cardiacfunction [2].
Cardiacfunction is poor, with akinesis of the LAD territory. If there had been — a temporary atrial pacemaker could have been considered as a way of increasing the heart rate to suppress a bradycardia-dependent arrhythmia ("overdrive pacing"). The echo images below were obtained on the day of presentation after PCI.
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