His bundle pacing (HBP) remains a hot topic in the field of cardiac electrophysiology. Included in our September 2019 issue of EP Lab Digest are two features pertaining to this technique:
His Bundle Pacing: Lessons from our Initial Experience
Rehan Mahmud, MD presents a brief case study describing his initial experience with His bundle pacing at McLaren Bay Region Hospital in Bay City, Michigan. Bonus video content shows a step-by-step demonstration of a His bundle implant.
Pacing Beyond the Site of Block: Left Bundle Branch Area Pacing in a Patient with Infranodal AV Block Following TAVR
Authors from Geisinger Heart Institute in Wilkes Barre, Pennsylvania write that while HBP is the preferred form of physiologic pacing, it is often not feasible in patients with block in the distal His bundle, as seen in patients undergoing transcatheter aortic valve replacement (TAVR). In their case report, they describe the feasibility of pacing beyond the site of block in the proximal left bundle in a patient with left bundle branch block and complete infranodal AV block following TAVR. Left bundle branch area pacing (LBBP) was associated with excellent pacing parameters.