Permanent His bundle pacing at the time of atrioventricular node ablation: A 3- dimensional mapping approach Sukit Ringwala, MD, MPH, Bradley P. Knight,

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Presentation transcript:

Permanent His bundle pacing at the time of atrioventricular node ablation: A 3- dimensional mapping approach Sukit Ringwala, MD, MPH, Bradley P. Knight, MD, FHRS, Nishant Verma, MD, MPH HeartRhythm Case Reports Volume 3, Issue 6, Pages 323-325 (June 2017) DOI: 10.1016/j.hrcr.2017.04.005 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Three dimensional map of the His cloud, final permanent His bundle lead position, and site of AV node ablation: 3D map showing final permanent His bundle lead location (white arrow). The yellow dots represent His points collected during electroanatomic mapping. The red dot represents the site of AV node ablation at a more proximal location relative to the His bundle lead. LAO = left anterior oblique; RAO = right anterior oblique. HeartRhythm Case Reports 2017 3, 323-325DOI: (10.1016/j.hrcr.2017.04.005) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Intracardiac electrograms during permanent His bundle lead threshold testing: With decreasing outputs during threshold testing of the permanent His bundle lead, loss of his capture and retrograde His activation are shown on the octopolar mapping catheter (curved red arrows and dashed arrows). This is accompanied by a subtle change in QRS morphology, but a clear increase in QRS duration (red circles). HeartRhythm Case Reports 2017 3, 323-325DOI: (10.1016/j.hrcr.2017.04.005) Copyright © 2017 Heart Rhythm Society Terms and Conditions