His-bundle pacing from the right atrium: Solving pacemaker implantation challenges post-TriClip

J Cardiovasc Electrophysiol. 2024 Nov;35(11):2258-2261. doi: 10.1111/jce.16431. Epub 2024 Sep 10.

Abstract

Introduction: This case report highlights the novel role of His-bundle pacing (HBP) from right atrium, not just for preserving cardiac function, but also for avoiding interference with TriClip devices.

Methods and results: A 78-year-old female with severe tricuspid regurgitation received two TriClip devices. Postprocedure, frequent significant sinus pauses required a pacemaker. HBP was chosen to avoid lead complications. Under local anesthesia, a His pacing lead was inserted via the axillary vein using specialized catheter. Follow-ups over 2.5 years showed stable parameters with no complications.

Conclusion: HBP is effective for patients with TriClip devices, ensuring optimal cardiac function and lead stability.

Keywords: His‐bundle pacing; TriClip; conduction system pacing; pacemaker; tricuspid regurgitation.

Publication types

  • Case Reports

MeSH terms

  • Action Potentials
  • Aged
  • Bundle of His* / physiopathology
  • Cardiac Pacing, Artificial*
  • Female
  • Heart Atria / physiopathology
  • Heart Atria / surgery
  • Heart Rate
  • Humans
  • Pacemaker, Artificial*
  • Treatment Outcome
  • Tricuspid Valve Insufficiency / diagnostic imaging
  • Tricuspid Valve Insufficiency / physiopathology
  • Tricuspid Valve Insufficiency / surgery