Methods and results
Patients with PICM were continuous enrolled from January 2018 to March
2020. All patients were further divided into AF subgroup and sinus
rhythm subgroup. Clinical data including echocardiographic examination
parameters, electrocardiogram (ECG) measurements, and New York Heart
Association (NYHA) classification, were assessed before and after a
his-purkinje system pacing (HPSP) upgrade. The HBP and LBBP upgrades
were completed in 34 of 36 (94%), Complications including electrode
dislodged, perforation, infection or thrombosis were not observed in
perioperative period. During a mean of 11.52±5.40 months of follow-up.
The left ventricular ejection fraction (LVEF) increased significantly
(33.76±7.54 vs 40.41±9.06, P<0.001), and the QRS duration
decreased (184.22±23.76ms vs 120.52±16.67ms, P<0.001) after
the HBP upgrades. LVEDD reversed from 59.29±7.74 mm to 53.91±5.92 mm
(P<0.001), and the NYHA functional class also improved to
2.00±0.76 from 2.55±0.91 at the first follow-up (P<0.001). The
left atrium (LA) size also slightly decreased compared to the initial
state (47.44±7.14mm VS 45.56±7.78, P=0.010). The threshold did not
increase significantly (1.18±0.76 mv@0.4ms vs 1.26±0.91mv @ 0.4ms,
P=0.581). These improvements in patients with AF were similar with those
in patients without AF (P >0.05).