Effectiveness and safety of AV node ablation after His bundle pacing in patients with uncontrolled atrial arrhythmias.

Autor: Moriña-Vázquez P; Department of Cardiology, Arrhythmia Unit, Hospital Juan Ramon Jimenez [HJRJ], Ronda norte s/n, Huelva, Spain., Moraleda-Salas MT; Department of Cardiology, Arrhythmia Unit, Hospital Juan Ramon Jimenez [HJRJ], Ronda norte s/n, Huelva, Spain., Arce-León Á; Department of Cardiology, Arrhythmia Unit, Hospital Juan Ramon Jimenez [HJRJ], Ronda norte s/n, Huelva, Spain., Venegas-Gamero J; Department of Cardiology, Arrhythmia Unit, Hospital Juan Ramon Jimenez [HJRJ], Ronda norte s/n, Huelva, Spain., Fernández-Gómez JM; Department of Cardiology, Arrhythmia Unit, Hospital Juan Ramon Jimenez [HJRJ], Ronda norte s/n, Huelva, Spain., Díaz-Fernández JF; Department of Cardiology, Hemodynamic Unit, HJRJ, Ronda norte s/n, Huelva, Spain.
Jazyk: angličtina
Zdroj: Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2021 Jun; Vol. 44 (6), pp. 1004-1009. Date of Electronic Publication: 2021 May 18.
DOI: 10.1111/pace.14252
Abstrakt: Introduction: In patients with uncontrolled atrial fibrillation, atrioventricular (AV) node ablation after permanent His bundle pacing (p-HBP) could be a therapeutic option for heart rate (HR) control. We aimed to demonstrate the advantages of AV node ablation with p-HBP, and to describe its effectiveness and safety.
Methods: This descriptive observational study included patients with uncontrolled permanent atrial arrhythmias who were candidates for HR control (January 2019 to July 2020) and underwent p-HBP and AV node ablation.
Results: A total of 39 patients were included. The median left ventricular ejection fraction (LVEF) was 55% (45-60); 46.1% in NYHA class II and 43.6% in NYHA class III. p-HBP was achieved in 92.3% (n = 36), and AV node ablation was successfully performed in all patients. The LVEF improved in patients with reduced LVEF (baseline, 35% [23.8-45.3%]; follow-up, 40% [35-56.5%], p < 0.05); the NYHA class also showed improvement (baseline, 71.4% patients in class III and 7.1% in class II, and at follow-up, 78.6% patients in class II and 14.3% in class I). In patients with previously normal LVEF, LVEF remained stable; nevertheless, a significant NYHA class improvement was observed (baseline, 63.6% class II and 31.8% class III patients; follow-up, 54.5% class I and 45.5% class II patients). The His thresholds and lead parameter values did not significantly change during the follow-up and remained stable.
Conclusions: In patients with uncontrolled atrial arrhythmias who underwent AV node ablation after p-HBP, the NYHA class improved and the LVEF increased in those with reduced baseline LVEF. The values of pacing parameters were acceptable and remained stable during the follow-up.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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