HeartRhythm Case Reports | 2019
A feasible approach for His bundle pacing using a novel mapping system in patients receiving pacemaker therapy
Abstract
Permanent His bundle pacing (HBP) has emerged as a new, promising approach to deliver physiological pacing, maintaining long-term ventricular synchrony and left ventricular performance unlike conventional right ventricular apical pacing, for treatment of patients with symptomatic bradycardia.1 Traditionally HBP is performed under fluoroscopic guidance, which entails significant exposure to radiation. A\xa0novel nonfluoroscopic three-dimensional (3D) cardiac imaging and navigation system, the KODEX-EPD system (EPD Solutions, Philips, Best, The Netherlands), offers an efficient way of guidance via high-definition (HD) computed tomography–like cardiac imaging and visualization of the His bundle region. It allows precision navigation with spatial resolution of 0.27 mm, HD anatomical imaging, tissue imaging, and physical property imaging. Less complicated than other 3D mapping systems, this electroanatomic mapping system was automatic without an electrophysiology (EP) catheter. We present a case of a 76-year-old man with sick sinus syndrome, in whom the KODEX-EPD system was successfully used to guide an implant of a dual-chamber pacemaker with HBP.