His bundle pacing – Poland at the forefront of countries implementing the new method
Direct pacing of the His bundle is a relatively new therapeutic method, first described in 2000. Consists of implanting an electrode directly into a component of the bundle His bundle stimulus system. This allows the most favorable depolarization of the ventricle r, because during stimulation the natural physiological pathway of impulse propagation is used. In the literature, His bundle stimulation is described as an effective type of stimulation in patients with permanent atrial fibrillation with slow rate and chronic heart failure.
It looks like this method will continue to develop, although, like any pacing method, this one also has to be learned. I think that in 5-10 years this will be one of the main in some ways in ventricular pacing. The current challenge for today remains the training of operators , which ers to use this method with as low a risk of complications as possible, and at the same time with very high efficacy and in an acceptable time frame.
At the moment, implanting a pacemaker is a procedure that takes tens of minutes (even 20 to 40 minutes in the absence of complex problems in anatomical). The implantation of the electrode into the His bundle, at least initially, takes more time. It is worth recalling that it used to be the same for pacemakers In biventricular or systemic in resynchronization pacemakers – right now the timing of the procedure is significantly kr tier than in the first months and years of its use.
Reports presented at the Europace 2019 congress indicate that the hemodynamic effect of bundle of Hisa pacing is significantly better than that of standard pacing. This is important in dw ch cases: in those patients who Those who already have a damaged heart (have heart failure) and those who ers need to have a pacemaker implanted, but do not have significant heart disease – as a result, their prognosis og lne is good. The idea is that in 20 years these patients will feel nie well as today.
Poland is among the leading ce, in terms of developing j His bundle stimulation – We have some excellent operators , which ers who can perform this procedure very well and, most importantly, want to train others. We have, as a country, great potential in this area – Poland has always been at the forefront of implantation of modern devices. At the Europace 2019 congress, the only Polish work that ra has been om The Congress Highlights session included a paper on bundle-branch pacing from the group of Professor Marek Jastrzębski (Krak ). At this year's and next year's conference of the Cardiac Rhythm Section of the Polish Society of Cardiology POLSTIM 2019 and 2020, we expect many interesting papers and discussions on bundle-branch pacing – no longer based on the available literature, but on our own experience in our Polish centers .
Author: prof. Przemyslaw Mitkowski – Faculty Member EHRA Europace 2019. Heart Rhythm Section of the Polish Society of Cardiology