期刊
HEART RHYTHM
卷 19, 期 7, 页码 1116-1123出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2022.03.1222
关键词
Atrial fibrillation; Atrioventricular junction ablation; Conduction system pacing; His-bundle pacing; Left bundle branch area pacing
AVJA with left bundle branch area pacing (LBBAP) leads shows a higher success rate and fewer lead-related complications.
BACKGROUND Single-center studies have shown feasibility of conduction system pacing (CSP) via His-bundle pacing (HBP) or left bundle branch area pacing (LBBAP) in atrial fibrillation (AF) patients undergoing atrioventricular junction ablation (AVJA). OBJECTIVE The purpose of this study was to compare outcomes in patients with HBP and LBBAP leads undergoing AVJA. METHODS Consecutive patients with CSP leads referred for AVJA between October 2014 and May 2021 were included. Pacing lead characteristics, procedural characteristics, complications, and long-term outcomes were assessed. RESULTS One hundred five AVJA procedures (55 HBP, 50 LBBAP) were performed in 98 patients (48 HBP, 50 LBBAP). The acute success rate of the AVJA procedure was 94% vs 100% (P = .11) in HBP vs LBBAP groups. Seven (14%) redo AVJA procedures were required in the HBP group. Mean procedural time (44 +/- 24 min vs 34 +/- 16 min; P = .02) and mean fluoroscopy time (16 +/- 18 min vs 7 +/- 6 min; P< .001) were significantly longer in the HBP vs LBBAP group. An acute rise in threshold was noted in 8 cases (14.5%), and 4 (8%) developed exit block after AVJA in HBP patients. Chronic HBP threshold >= 2.5 V was seen in 23 patients (48%), and 4 (8%) HBP leads were deactivated. CSP preserved ejection fraction (EF) in the overall cohort (N = 70; 53% +/- 10% vs 55% +/- 10%; P = .09) and significantly improved in those with reduced EF<50% at baseline (N = 16; 37% +/- 7.6% vs 46% +/- 13%; P = .02). CONCLUSION AVJA in the presence of an LBBAP lead is associated with a higher success rate and fewer acute and chronic lead-related complications. CSP with either HBP or LBBAP preserves left ventricular systolic function in patients with refractory atrial fibrillation post AVJA.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据