Heart rhythm · 2026
Insights from 10-year follow-up of His bundle pacing: A multicenter experience.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zanon Francesco, Marcantoni Lina, Subzposh Faiz A, Deluca Francesco, Valenza Simone, Porcelli Giorgio, Picariello Claudio, Roccabruna Alessandra, Jannello Elena Maria Santina, Stievano Angela, Pastore Gianni, Vijayaraman Pugazhendhi
Аннотация
BACKGROUND: His bundle pacing (HBP) provides physiological ventricular activation by engaging the native His-Purkinje system. Although midterm safety and efficacy are established, long-term outcomes beyond 5 years remain insufficiently defined.
OBJECTIVE: This study aimed to evaluate long-term performance, device behavior, and clinical outcomes of permanent HBP over a follow-up period of up to 10 years.
METHODS: We retrospectively analyzed 500 consecutive patients who underwent successful HBP between 2003 and 2013 at 2 high-volume centers. Clinical, device, and echocardiographic data were collected at scheduled in-person and remote evaluations. Outcomes included pacing thresholds, sensing, lead-related events, device longevity, left ventricular ejection fraction (LVEF), hospitalizations, and mortality. Time-to-event analyses were performed using Kaplan-Meier estimates and Cox regression.
RESULTS: Follow-up data were available for 487 patients (mean age 75 ± 9 years) with a mean duration of 7.9 ± 4.7 years; 193 patients completed ≥10 years of follow-up. Selective HBP was achieved in 51%. Lead-related events occurred in 12.1% of patients, most commonly capture threshold rise (10.5%); lead dislodgment was rare (0.8%). Battery depletion occurred in 66.6% at 10 years. Backup leads were associated with reduced device longevity (hazard ratio 1.87; P < .001). Overall, LVEF remained stable; 30.7% showed ≥5% improvement in LVEF, particularly among those with a baseline LVEF of <45%. All-cause mortality was 38.2%, predominantly noncardiac.
CONCLUSION: This large multicenter experience demonstrates that HBP is a safe and effective pacing strategy with durable performance, acceptable device longevity, and stable ventricular function over a decade of follow-up. Technical issues-primarily threshold rise-are generally manageable. These findings provide the longest longitudinal data to date supporting HBP as a reliable physiological pacing modality.
OBJECTIVE: This study aimed to evaluate long-term performance, device behavior, and clinical outcomes of permanent HBP over a follow-up period of up to 10 years.
METHODS: We retrospectively analyzed 500 consecutive patients who underwent successful HBP between 2003 and 2013 at 2 high-volume centers. Clinical, device, and echocardiographic data were collected at scheduled in-person and remote evaluations. Outcomes included pacing thresholds, sensing, lead-related events, device longevity, left ventricular ejection fraction (LVEF), hospitalizations, and mortality. Time-to-event analyses were performed using Kaplan-Meier estimates and Cox regression.
RESULTS: Follow-up data were available for 487 patients (mean age 75 ± 9 years) with a mean duration of 7.9 ± 4.7 years; 193 patients completed ≥10 years of follow-up. Selective HBP was achieved in 51%. Lead-related events occurred in 12.1% of patients, most commonly capture threshold rise (10.5%); lead dislodgment was rare (0.8%). Battery depletion occurred in 66.6% at 10 years. Backup leads were associated with reduced device longevity (hazard ratio 1.87; P < .001). Overall, LVEF remained stable; 30.7% showed ≥5% improvement in LVEF, particularly among those with a baseline LVEF of <45%. All-cause mortality was 38.2%, predominantly noncardiac.
CONCLUSION: This large multicenter experience demonstrates that HBP is a safe and effective pacing strategy with durable performance, acceptable device longevity, and stable ventricular function over a decade of follow-up. Technical issues-primarily threshold rise-are generally manageable. These findings provide the longest longitudinal data to date supporting HBP as a reliable physiological pacing modality.