His bundle pacing guided by automated intrinsic morphology matching is feasible in patients with narrow QRS complexes

Bastian D, Gregorio C, Buia V, Walaschek J, Rittger H, Vitali-Serdoz L (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Scientific Reports Nature Publishing Group: Open Access Journals - Option B

Book Volume: 12

Article Number: 3606

Journal Issue: 1

DOI: 10.1038/s41598-022-07516-6

Abstract

Pace mapping and visual comparison of the local pacing response with the intrinsic QRS morphology form the mainstay of His bundle pacing (HBP). We evaluated the performance of a surface lead morphology match algorithm for automated classification of the pacing response in patients with narrow intrinsic QRS undergoing electroanatomic mapping (EAM)-guided HBP. HBP was attempted in 43 patients. In 28 cases with narrow QRS, the EnSite AutoMap Module was used for automated assessment of the QRS morphology resulting from pace mapping in the His cloud area with either a diagnostic catheter or the His lead. An intrinsic morphology match score (IMS) was calculated for 1.546 QRS complexes and assessed regarding its accuracy and performance in classifying the individual pacing response as either selective HBP (S-HBP), nonselective HBP (NS-HBP) or right ventricular stimulation. Automated morphology comparison of 354 intrinsic beats with the individual reference determined a test accuracy of 99% (95% CI 98.96–99.04) and a precision of 97.99–99.5%. For His-lead stimulation, an IMS ≥ 89% identified S-HBP with a sensitivity, specificity and positive predictive value of 1.00 (0.99, 1.00) and a negative predictive value of 0.99 (0.98, 1.00). An IMS between 78 and < 89% indicated NS-HBP with a sensitivity and specificity of 1.00 (0.99, 1.00) and 0.99 (0.98, 1.00), respectively. IMS represents a new automated measure for standardized individual morphology classification in patients with normal QRS undergoing EAM-guided HBP. Clinical trial registration: NCT04416958.

Involved external institutions

Klinikum Fürth DE Germany (DE) Università degli Studi di Trieste IT Italy (IT)

How to cite

APA:

Bastian, D., Gregorio, C., Buia, V., Walaschek, J., Rittger, H., & Vitali-Serdoz, L. (2022). His bundle pacing guided by automated intrinsic morphology matching is feasible in patients with narrow QRS complexes. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-022-07516-6

MLA:

Bastian, Dirk, et al. "His bundle pacing guided by automated intrinsic morphology matching is feasible in patients with narrow QRS complexes." Scientific Reports 12.1 (2022).

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