Acute Effects of His Bundle Pacing Versus Left Ventricular and Right Ventricular Pacing on Left Ventricular Function

Luigi Padeletti, Randy Lieberman, Jan Schreuder, Antonio Michelucci, Andrea Collella, Paolo Pieragnoli, Giuseppe Ricciardi, William Eastman, Sergio Valsecchi, Douglas A. Hettrick

Research output: Contribution to journalArticlepeer-review


Dual-chamber pacing with His bundle pacing has theoretical advantages over conventional right ventricular (RV) apical pacing. We compared indexes of left ventricular (LV) function during acute dual-chamber pacing from the His bundle and other RV and LV pacing sites. Twelve patients (6 men; 63 ± 11 years) with a standard indication for electrophysiologic study were included. Average QRS duration was 100 ± 19 ms. Ejection fraction was 48 ± 15%. A pressure-volume catheter was positioned in the left ventricle through the femoral arterial access. Pressure-volume loops were collected during atrial (AAI) and dual-chamber overdrive pacing at 82 ± 15 beats/min after 2 minutes of hemodynamic stabilization. Ventricular pacing catheter position was randomized between the RV apex, RV septal, and free wall portions of the outflow tract, LV free wall, and His bundle. His bundle capture was verified from surface electrocardiographic morphometry using standard criteria. Atrioventricular delay was set to the P wave-His duration -10 ms to minimize the effects of fusion (96 ± 22 ms). LV only pacing, but not His pacing, resulted in improved stroke work and stroke volume compared with alternate site RV pacing. No changes in +dP/dt, LV end-systolic pressure. LV end-diastolic pressure, or cycle efficiency, were observed between RV pacing sites. In conclusion, acute His bundle pacing did not improve LV function compared with alternate site RV pacing and may be inferior to LV pacing.

Original languageEnglish
Pages (from-to)1556-1560
Number of pages5
JournalThe American Journal of Cardiology
Issue number10
Publication statusPublished - Nov 15 2007

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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