Open Access Research Article

Comparative Analysis of His Bundle Versus Septal Versus Right Ventricuar Apical Pacing- A Short Term Follow up Study

Sudeb Mukherjee*, Asit Das and SC Mandal

Department of Cardiology, IPGME&R-SSKM Hospital, India

Corresponding Author

Received Date:June 27, 2020;  Published Date: July 20, 2020


Introduction: His Bundle Pacing (HBP) is devoid of consequences of remodelling induced by Right Ventricular Apical Pacing (RVAP). Septal pacing has also been studied in several studies. Complications of heart failure, chamber dilatation and QRS prolongation are not seen in HBP and less in septal pacing. This study was done to evaluate outcomes of HBP versus Septal pacing versus RVAP in those patients requiring pacing.

Methods: Total 100 patients with atrio ventricular block with syncope who required pacing were included in this study. 50 patients underwent RVAP, 38 patients septal pacing and 12 patients underwent His bundle pacing. Detail echocardiogram-based parameters were obtained before and post pacing 6 months. All data collected appropriately and analysed accordingly using SPSS software by 1-way ANOVA with the use of the Holm-Sidak method for pairwise multiple comparisons or by the χ2 test, as appropriate. The statistical test of main treatment effect was an adjusted F test with Kenward-Roger type adjustment of denominator degrees of freedom.

Results: HBP was associated with improvements in Left Ventricular Ejection Fraction (LVEF) and other chamber dimension which was statistically significant. Septal pacing was found to be better (not statistically significant although numerically better) compared to RVAP group which showed deterioration of LVEF, chamber dimension and QRS duration.

Conclusion: HBP was found to be more physiological than septal and RVAP group although technically challenging and required expertise.

Keywords: His Bundle Pacing (HBP); Septal pacing; Right Ventricular Apical Pacing RVAP); Left Ventricular Ejection Fraction (LVEF)

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