Abstract

GOMEZ-FLORES, Jorge et al. Management of heart failure with His bundle pacing in right bundle branch block: case report. Arch. Cardiol. Méx. [online]. 2021, vol.91, n.1, pp.93-99.  Epub Mar 09, 2021. ISSN 1665-1731.  https://doi.org/10.24875/acm.19000402.

Cardiac resynchronization therapy has proven to be an effective therapy in patients with left bundle branch block and heart failure. Male, 47 years old, heart failure with a left ventricle ejection fraction of 17%, idiopathic heart failure. ECG with sinus rhythm, 1st degree AV block, PR 400 ms, complete right bundle branch block, anterior hemi-fascicle of the left bundle of His, and QRS duration 200 ms. We decided to perform a selective His bundle pacing. In patients with right bundle branch block the biventricular cardiac resynchronization is not indicated due to low treatment response. His bundle pacing allows recruiting the blocked branch and restoring conduction throughout it, therefore, in the absence of necrosis the biventricular synchrony is achieved. We presented a case of His bundle pacing with recruitment of the right bundle branch, which reestablish biventricular synchrony measured by speckle tracking, and with a significant increase of the left ventricle ejection fraction from 17 to 36.6%, with an absolute increase of 19.6%.

Keywords : Cardiac resynchronization; Right bundle branch block; His bundle pacing; Heart failure; México.

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