Introduction

His bundle pacing (HBP) has become popular in recent years as a more physiological alternative to conventional right ventricular pacing. Implantation requires 12‑lead ECG during surgery, which is not readily available in a standard operating room. Often but not always HBP is performed in an electrophysiology lab. EASI is a reduced lead system which enables derived 12‑lead ECG. EASI derived 12‑lead ECGs on modern tablet computers offer a more mobile and lightweight ECG solution which does not obstruct fluoroscopy during implantation. This case series aims to compare standard 12‑lead ECG to EASI derived 12‑lead ECG in patients undergoing HBP implantation.

Methods and results

A total of 11 patients received permanent HBP guided only by fluoroscopy, a pacing system analyzer (Medtronic CareLink SmartSync Device Manager) and EASI derived 12‑lead ECG (CardioSecur Pro). During the first postoperative device interrogation HBP criteria, as defined in the EHRA consensus paper on conduction system pacing, were evaluated with the EASI derived system as well as a standard 12‑lead ECG and compared to each other. There was perfect agreement with regards to these criteria which lead to identical conclusions in all cases.

Conclusion

HBP implantation can be performed with EASI derived 12‑lead ECG instead of conventional 12‑lead ECG. Criteria for discriminating between selective His bundle, non-selective His bundle or myocardial capture alone are clearly visible in the EASI derived ECG leading to the same conclusion when compared to standard 12‑lead ECG. Compared to a conventional 12‑lead ECG the EASI system offers a leaner setup with less visual obstruction on fluoroscopy.

中文翻译：

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EASI 衍生的 12 导联心电图促进希氏束起搏的可行性

介绍

近年来，束束起搏（HBP）作为传统右心室起搏的一种更符合生理学的替代方案而变得流行。植入在手术期间需要 12 导联心电图，这在标准手术室中是不容易获得的。通常但并非总是 HBP 在电生理学实验室进行。EASI 是一种减少导联系统，可生成 12 导联心电图。现代平板电脑上的 EASI 衍生 12 导联心电图提供了更加移动和轻便的心电图解决方案，在植入过程中不会妨碍透视检查。本病例系列旨在将接受 HBP 植入的患者的标准 12 导联心电图与 EASI 衍生的 12 导联心电图进行比较。

方法和结果

总共 11 名患者仅在透视、起搏系统分析仪 (Medtronic CareLink SmartSync Device Manager) 和 EASI 衍生的 12 导联心电图 (CardioSecur Pro) 的引导下接受了永久性 HBP。在第一次术后设备询问期间，根据 EHRA 关于传导系统起搏的共识文件中定义的 HBP 标准，使用 EASI 衍生系统以及标准 12 导联心电图进行评估，并进行相互比较。这些标准完全一致，在所有情况下都得出相同的结论。

结论

HBP 植入可以使用 EASI 衍生的 12 导联心电图而不是传统的 12 导联心电图进行。区分选择性希氏束、非选择性希氏束或单独心肌夺获的标准在 EASI 衍生心电图中清晰可见，与标准 12 导联心电图相比，得出相同的结论。与传统的 12 导联心电图相比，EASI 系统提供了更精简的设置，荧光检查时的视觉障碍更少。