English Polski
Vol 12, No 3 (2017)
Case report
Published online: 2017-06-30

open access

Page views 719
Article views/downloads 1194
Get Citation

Connect on Social Media

Connect on Social Media

Unusually high His-bundle signal amplitude — ICD sensing considerations

Agnieszka Sławuta1, Jakub Adamowicz1, Magdalena Sokołowska2, Aleksandra Gajek2, Martek Frączkowski1, Jacek Gajek3
Folia Cardiologica 2017;12(3):295-297.

Abstract

In patients with chronic atrial fi brillation and congestive heart failure presenting with narrow QRS complex the direct
His-bundle pacing the use of dual chamber implantable cardioverter-defibrillator can be a defi nite treatment option
meeting all therapeutic goals. This approach enables heart rate regularization, appropriate increase of beta-blocker
dose with additional benefi t in terms of arrhythmic death prophylaxis. The proper functioning of implantable cardioverter-
-defibrillator demands appropriate atrial channel/His-bundle signal sensing. The low His-bundle electrogram amplitude
usually does not interfere with the device function and the DDI or DVI programming modes are reasonable.

The authors present a case of unusually high His-bundle signal amplitude sensed by atrial channel of implantable cardioverter-defibrillator, which could potentially contribute to some particular programming considerations. The attending physician should be aware of some arrhythmia discriminators which may delay or even withhold the appropriate shock.

References

  1. Sławuta A, Mazur G, Małecka B, et al. Permanent His bundle pacing - An optimal treatment method in heart failure patients with AF and narrow QRS. Int J Cardiol. 2016; 214: 451–452.
  2. Clark DM, Plumb VJ, Epstein AE, et al. Hemodynamic effects of an irregular sequence of ventricular cycle lengths during atrial fibrillation. J Am Coll Cardiol. 1997; 30(4): 1039–1045.
  3. Deshmukh P, Casavant DA, Romanyshyn M, et al. Permanent, direct His-bundle pacing: a novel approach to cardiac pacing in patients with normal His-Purkinje activation. Circulation. 2000; 101(8): 869–877.
  4. Sławuta A, Biały D, Zyśko D, et al. His-bundle pacing using dual-chamber cardioverter–defibrillator in patients with chronic atrial fibrillation: different pacing and sensing features. Acta Cardiol. 2017 [ahead-of-print]: 1–2.