Paradoxical Para-Hisian Pacing Response

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Han Efe T., Merovci I., Yunus Calapkulu M., Ozdemir Al C., Kara M., Kocyigit Burunkaya D., ...More

Journal of Innovations in Cardiac Rhythm Management, vol.14, no.6, pp.5488-5490, 2023 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 14 Issue: 6
  • Publication Date: 2023
  • Doi Number: 10.19102/icrm.2023.14063
  • Journal Name: Journal of Innovations in Cardiac Rhythm Management
  • Journal Indexes: Scopus
  • Page Numbers: pp.5488-5490
  • Keywords: Atrioventricular re-entrant tachycardia, elecrophysiological maneuvers, para-Hisian pacing
  • Istanbul Medipol University Affiliated: Yes

Abstract

Para-Hisian pacing (PHP) is among the most useful maneuvers in cardiac electrophysiology during sinus rhythm and identifies whether retrograde conduction is dependent on the atrioventricular (AV) node. In this maneuver, the retrograde activation time and pattern are compared during capture and loss of capture of the His bundle while pacing from a paraHisian position. A common misconception about PHP is that it is useful only for septal accessory pathways (APs). However, even with left or right lateral pathways, as long as pacing from the para-Hisian region conducts to the atrium with the activation sequence being analyzed, it can be used to determine whether that activation is AV node–dependent or AP-dependent.