Implantation technique of His bundle pacing.

His bundle pacing (HBP) preserves physiological ventricular synchrony, with clinical benefits particularly evident when a high percentage of ventricular pacing is required. First experiences with standard leads and manually shaped stylets produced the impression that HBP is highly complex and time-consuming. However, with dedicated leads and sheaths, reliable HBP can be achieved in routine clinical practice.

Electrogram-only guided approach to His bundle pacing with minimal fluoroscopy: A single-center experience.

Introduction: His bundle pacing (HBP) is the most physiological pacing. The standard technique based on fluoroscopic approach might be challenging and fluoro consuming. Targeting the His guided exclusively by the electrical signals could enable a precise lead implant, thus reducing fluoroscopy time (FT) and X-ray dose, desirable both for patients and operators.

Long term performance and safety of His bundle pacing: A multicenter experience.

Introduction: Several single-center short-term studies have demonstrated the feasibility, safety, and positive clinical outcomes of permanent His bundle pacing (HBP). We performed a retrospective study to evaluate long-term technical and safety performances of HBP in a large population of pacemaker patients from two different centers.

Methods And Results: The analysis includes 844 patients (345 female, mean age = 75 ± 9 years) who underwent successful permanent HBP for pacemaker indications from 2004 to 2016.

The risk of atrial fibrillation during right ventricular pacing.

Aims: Right ventricular pacing adversely affects left atrial (LA) structure and function that may trigger atrial fibrillation (AF). This study compares the occurrence of persistent/permanent AF during long-term Hisian area (HA), right ventricular septal (RVS), and right ventricular apex (RVA) pacing in patients with complete/advanced atrioventricular block (AVB).

Methods And Results: We collected retrospective data from 477 consecutive patients who underwent pacemaker implantation for complete/advanced AVB.

In-hospital follow-up of implantable cardioverter defibrillator and pacemaker carriers: patients' inconvenience and points of view. A four-hospital Italian survey.

Aims: The increasing volume of pacemaker (PM) and implantable cardioverter defibrillator (ICD) implants and problems related to their functioning have highlighted the issue of device follow-ups. Patients' convenience regarding device visits has been little investigated. This work aims at surveying patients' efforts in attending the in-office PM/ICD follow-ups and at evaluating their expectations.

Ventricular-arterial coupling in patients with heart failure treated with cardiac resynchronization therapy: may we predict the long-term clinical response?

Objective: To evaluate the effects of cardiac resynchronization therapy (CRT) on ventricular-arterial coupling (VAC) in patients with refractory congestive heart failure (HF), left bundle brunch block, and sinus rhythm.

Background: The ratio between arterial elastance (Ea) and left ventricular end-systolic elastance (Ees), the so-called VAC, defines the efficiency of the myocardium in pumping blood.

Methods: Seventy-eight patients were studied with echocardiography before CRT, and 1 year later.

Implantation of left ventricular leads using a telescopic catheter system.

Background: Implantation procedures for cardiac resynchronization therapy (CRT) remain challenging with regard to coronary sinus (CS) cannulation and left ventricular (LV) lead positioning. Technologic advances in catheter design may facilitate CS cannulation and LV lead placement.

Aims: To evaluate two different telescoping dual-catheter systems, RAPIDO Guiding Catheter System (Group R) and RAPIDO ADVANCE Guiding Catheter System (Group A) (Guidant Inc.

A feasible approach for direct his-bundle pacing using a new steerable catheter to facilitate precise lead placement.

Introduction: Much clinical evidence has shown that right ventricular (RV) apical pacing is detrimental to left ventricular function. Preservation of the use of the His-Purkinje (H-P) system may be ideal in heart block that is restricted to the AV node, but may be of no benefit when H-P disease exists.

Aim: To investigate the feasibility of direct His-bundle pacing (DHBP) using a new system consisting of a steerable catheter and a new 4.