Clinical impact of Bachmann's bundle pacing defined by electrocardiographic criteria on atrial arrhythmia outcomes.

Atrial fibrillation Atrial resynchronization Atrial septal pacing Bachmann’s bundle pacing Electrocardiograph Interatrial conduction delay P-wave Right atrial appendage pacing Sinus node dysfunction

Journal

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
ISSN: 1532-2092
Titre abrégé: Europace
Pays: England
ID NLM: 100883649

Informations de publication

Date de publication:
13 10 2022
Historique:
received: 08 11 2021
accepted: 18 02 2022
pubmed: 20 3 2022
medline: 18 10 2022
entrez: 19 3 2022
Statut: ppublish

Résumé

Evaluate whether Bachmann's bundle pacing (BBp) defined by electrocardiographic (ECG) criteria is associated with less atrial fibrillation/tachycardia (AF/AT) compared with anatomically defined right atrial septal pacing (RASp) and right atrial appendage pacing (RAAp). This is a retrospective study comparing BBp with non-specific RASp and RAAp on new incidence, burden, and recurrence of AF/AT. We included patients who underwent atrial lead placement between 2006 and 2019 and received > 20% atrial pacing. BBp was defined by paced P-wave morphology and fluoroscopic lead position. Compared with RASp (n = 107) and RAAp (n = 108), AF/AT burden was lower in the BBp (n = 134) group by repeated measures ANOVA (P < 0.001). Over 2-year follow-up, AF/AT burden increased in the RASp (P < 0.01) and RAAp (P < 0.01) groups but did not significantly change in the BBp group (P = 0.91). Atrial arrhythmia burden was lower in the BBp group than the RASp and RAAp groups at 12-15, 18-21, and 24-27 months (P < 0.05) after pacemaker placement. Risk of AF/AT recurrence was lower in BBp than RASp (HR 0.43; P < 0.01) and RAAp patients (HR 0.29, P < 0.01). Risk of de novo AF/AT was also lower in BBp than in RASp (OR 0.12; P < 0.01) and RAAp patients (OR 0.20, P < 0.01). Bachmann's bundle pacing defined using P-wave criteria was associated with decreased atrial arrhythmia burden, recurrence, and de novo incidence compared with right atrial septal pacing and right atrial appendage pacing.

Identifiants

pubmed: 35304608
pii: 6550762
doi: 10.1093/europace/euac029
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1460-1468

Informations de copyright

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2022. For permissions, please email: journals.permissions@oup.com.

Déclaration de conflit d'intérêts

Conflict of interest: M.M. and the University of Vermont have licensed patents for the use of pacemakers for the prevention and treatment of heart failure with preserved ejection fraction. D.L.L. and M.M. have received research funding from Medtronic. Other authors report no competing interests.

Auteurs

Margaret Infeld (M)

Department of Medicine, Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.

Charles D Nicoli (CD)

Department of Medicine, Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.

Sean Meagher (S)

Department of Medicine, Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.

Bradley J Tompkins (BJ)

Department of Medicine, Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.

Shawn Wayne (S)

Department of Medicine, Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.

Benjamin Irvine (B)

Department of Medicine, Tulane University, New Orleans, Louisiana.

Omkar Betageri (O)

Department of Medicine, University of Florida, Gainesville, FL, USA.

Nicole Habel (N)

Department of Medicine, Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.

Sean Till (S)

Department of Medicine, Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.

Jennings Lobel (J)

Department of Medicine, Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.

Markus Meyer (M)

Department of Medicine, Lillehei Heart Institute, University of Minnesota, Minneapolis, MN, USA.

Daniel L Lustgarten (DL)

Department of Medicine, Larner College of Medicine, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.

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Classifications MeSH