Clinical Study Of The Effect Of His Bundle Pacing On Cardiac Function In Patients With Atrial Fibrillation With Reduced Ejection Fraction

Objective: To investigate whether the His bundle pacing is safe and feasible for patients with atrial fibrillation with reduced ejection fraction.The clinical effect of his bundle pacing on cardiac function in patients with atrial fibrillation with reduced ejection fraction.To compare the effect of His bundle pacing and traditional right ventricular apical pacing on cardiac function and cardiac structure.Method: A total of 23 patients with atrial fibrillation with Heart failure and slow ventricular rate requiring permanent pacemaker treatment in the Geriatric Department of Cardiology,The Second Affiliated Hospital of Anhui Medical University were selected from October 2018 to October 2019.Among them,9 were treated with his bundle pacing(reduced ejection fraction LVEF<50%)and 14 were treated with right ventricle pacing.The patients were followed up for 1 year.To evaluate the safety,feasibility and effect of his bundle pacing on cardiac function and structure of patients.Results :Among the 9 patients,7 patients were successfully performed his bundle pacing.Compared with preoperation(the last follow-up),The threshold and perception remained stable in patients with His bundle pacing(P>0.05),the NYHA cardiac function grade of the patients with his bundle pacing improved,left ventricular ejection fraction(LVEF)increased,and left ventricular end-diastolic diameter(LVEDD)decreased(P<0.05).14 patients were successfully performed right ventricular apex pacing.In patients with right ventricular apex pacing,there were no significant changes in LVEF and LVEDD(P > 0.05),post-operative hospitalization rate increased,and QRS prolonged.Conclusion:In patients with atrial fibrillation with reduced ejection fraction,His bundle pacing is safe and feasible,and the pacing parameters are stable within 1 year.It can maintain ventricular electromechanical synchrony and good cardiac hemodynamics,that significantly improve cardiac function.Compared with right ventricular apical pacing,it has important value for patients with heart failure.As the most physiological cardiac pacing method,it is expected to be an alternative to traditional right ventricular apical pacing and CRT.