HIS Bundle Pacing

His bundle pacing

by Dave H - 2020-03-21 12:33:30

I'd say, since your location is in Ohio, the Cleveland Clinic would be an excellent start.  Mayo Clinic in Rochester, MN would be another provider. Personally, my EP - here in Texas - just last week attempted to use His pacing for me but, my complete BBB thwarted the Doc's effort.

Thank you Dave

by Good Dog - 2020-03-21 13:22:52

I have been to the Cleveland Clinic and they will not do His pacing. That is exactly why I am asking. The Clinic suggested CRT as an alternative to HIS pacing for me. Thing is: I am trying to avoid extraction of my 33 year old leads. I already have two leads through the tricuspid valve and would need at least one of them removed. However, HIS pacing would preclude the need for a lead through that valve and therefore would not need extraction.

Thanks for your input!

Sincerely,

David

HBP

by Gotrhythm - 2020-03-21 13:59:21

I found HBP by looking up local medical centers, fortunately where I live there are several university hospitals. I read the background of every cardiologist until I found one.

That's how I did it. I like to do research.

I understand why you would hope to find someone close to home. But convenience isn't really the most important thing for those of us, who don't have just the standard-issue pacemaker conditions. Placing the lead in the His bundle takes extraordinary skill. We will do well travel if we must to get to someone with the kind of specialist knowledge and experience we need.

I have no knowledge of Ohio. When I researched HBP I learned Geisinger Heart Institute in Wilkes-Barre is a leader in HPB. They were doing it before anywhere else. And have more experience than just about anywhere.

Health Provider

by Theknotguy - 2020-03-21 14:00:57

You can also check with your health insurance provider.  They usually have an 800 help line.  Call and ask the same questions.  If you can get to a case  manager they can be very helpful.  Possibly even give you the name of a doctor within your health insurance.  And since they are able to work from home you still should be able to get through even though most group lines are shut down.  

I'm in the Columbus, Ohio area and I know of three hospitals in the area.  Grant, OSU, and Riverside.  Possibly more as they share doctors.  I know Riverside sent out a couple of people within the last month because I talked with them. 
 

Thank you all!

by Good Dog - 2020-03-21 14:12:58

I really appreciate all of your feed-back! The hospital that I had found in eastern PA is Geisinger Heart Institute in Wilkes-Barre. That was the closest to me so far, also perhaps the best, but I will also check-out those in Columbus that were suggested.

THANKS SO MUCH!!!

David

An LV lead for CRT wouldn't traverse the tricuspid valve

by crustyg - 2020-03-22 11:34:38

Usually the LV lead for CRT starts toward the LV (using the lateral vein) via the coronary sinus which is above the tricuspid valve.  So having a third lead added for CRT wouldn't need you to have your existing leads removed.

crustyg - LV Lead

by Good Dog - 2020-03-22 12:47:37

Understood. The third lead is not the problem. The problem is that both of my existing leads also need to be replaced. I already have two leads through the tricuspid valve. One is capped (recalled a year after my initial implant in 1987) and the other is active, but will need replacement. So with a CRT I will need three new leads. With HIS pacing, I would only need two new leads and there would be no need to pass one through the tricuspid valve. 

It may or may not be a possibility, so I will need a consult with a good EP that does HIS pacing to find-out for sure. I would have thought the Cleveland Clinic would do HIS pacing, which is why I had a consult with them. Avoiding extraction of 33+ year old leads eliminates a lot of risk. That is what I am shooting for.

Thanks for your input!

Additional lead

by AgentX86 - 2020-03-22 14:30:02

Can the same lead that has been used for RV apex placement be used for His pacing?  Can they be moved?  I'd think they'd use different attachment means and differ in shape to get to the right place (His placement isn't easy, AIUI).