Conversion to Sinus Rhythm in Refractory Atrial Fibrillation Patients after Atrioventricular Node Ablation with Conduction System Pacing.
His bundle pacing
atrial fibrillation
atrioventricular node ablation
conduction system pacing
left bundle branch pacing
sinus rhythm
Journal
Reviews in cardiovascular medicine
ISSN: 1530-6550
Titre abrégé: Rev Cardiovasc Med
Pays: Singapore
ID NLM: 100960007
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
09
04
2023
revised:
30
06
2023
accepted:
05
07
2023
medline:
30
7
2024
pubmed:
30
7
2024
entrez:
30
7
2024
Statut:
epublish
Résumé
"Ablate and pace" strategy is a reasonable treatment option in refractory atrial fibrillation (AF) when sinus rhythm (SR) cannot be achieved with catheter ablation or pharmacological therapy. Atrioventricular node ablation (AVNA) combined with conduction system pacing (CSP), with left bundle branch pacing (LBBP) or His bundle pacing (HBP), is gaining recognition since it offers the most physiological activation of the left ventricle. However, the incidence of conversion to SR after AVNA with CSP is not known. The purpose of the investigation was to determine the incidence of spontaneous conversion to SR and its predicting factors in patients undergoing CSP and AVNA. Consecutive refractory symptomatic AF patients undergoing AVNA with CSP at our institution between June 2018 and December 2022 were retrospectively analyzed. Twelve lead electrocardiogram (ECG) recordings were analyzed at each outpatient follow-up visit. Echocardiographic and clinical parameters were assessed at baseline and six months after the implantation. Sixty-eight patients (male 42.6%, age 71 Spontaneous conversion to SR after AVNA combined with CSP is not uncommon, especially in patients with smaller left atria. Further studies are warranted to clarify which patients should be considered for initial dual-chamber device implantation to provide atrio-ventricular synchrony in case of SR restoration.
Sections du résumé
Background
UNASSIGNED
"Ablate and pace" strategy is a reasonable treatment option in refractory atrial fibrillation (AF) when sinus rhythm (SR) cannot be achieved with catheter ablation or pharmacological therapy. Atrioventricular node ablation (AVNA) combined with conduction system pacing (CSP), with left bundle branch pacing (LBBP) or His bundle pacing (HBP), is gaining recognition since it offers the most physiological activation of the left ventricle. However, the incidence of conversion to SR after AVNA with CSP is not known. The purpose of the investigation was to determine the incidence of spontaneous conversion to SR and its predicting factors in patients undergoing CSP and AVNA.
Methods
UNASSIGNED
Consecutive refractory symptomatic AF patients undergoing AVNA with CSP at our institution between June 2018 and December 2022 were retrospectively analyzed. Twelve lead electrocardiogram (ECG) recordings were analyzed at each outpatient follow-up visit. Echocardiographic and clinical parameters were assessed at baseline and six months after the implantation.
Results
UNASSIGNED
Sixty-eight patients (male 42.6%, age 71
Conclusions
UNASSIGNED
Spontaneous conversion to SR after AVNA combined with CSP is not uncommon, especially in patients with smaller left atria. Further studies are warranted to clarify which patients should be considered for initial dual-chamber device implantation to provide atrio-ventricular synchrony in case of SR restoration.
Identifiants
pubmed: 39076439
doi: 10.31083/j.rcm2411333
pii: S1530-6550(23)01075-X
pmc: PMC11272869
doi:
Types de publication
Journal Article
Langues
eng
Pagination
333Informations de copyright
Copyright: © 2023 The Author(s). Published by IMR Press.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.