Safety and feasibility of conduction system pacing in patients with congenital heart disease.

Autor: Cano Ó; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.; Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain., Dandamudi G; Division of Cardiovascular Medicine, Cardiovascular Service Line, Cardiology, CHI-Franciscan Health System, Tacoma, Washington, USA., Schaller RD; Electrophysiology Section, Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Pérez-Roselló V; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain., Ayala HD; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain., Izquierdo M; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain., Osca J; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain., Sancho-Tello MJ; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain., Rueda J; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain., Ruiz E; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain., Insa B; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain., Martínez-Dolz L; Electrophysiology Section, Adult Congenital Heart Disease Section and Paediatric Cardiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.; Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain., Vijayaraman P; Division of Cardiovascular Medicine, Geisinger Heart Institute, Wilkes-Barre, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2021 Oct; Vol. 32 (10), pp. 2692-2703. Date of Electronic Publication: 2021 Aug 26.
DOI: 10.1111/jce.15213
Abstrakt: Introduction: Conduction system pacing (CSP) has emerged as an ideal physiologic pacing strategy for patients with permanent pacing indications. We sought to evaluate the safety and feasibility of CSP in a consecutive series of unselected patients with congenital heart disease (CHD).
Methods: Consecutive patients with CHD in which CSP was attempted were included. Safety and feasibility, implant tools and electrical parameters at implant and at follow-up were evaluated.
Results: A total of 20 patients were included (10 with a previous device). A total of 10 patients had complex forms of CHD, 9 moderate defects and 1 a simple defect. CSP was achieved in 75% of cases (10 His bundle pacing, 5 left bundle branch pacing) with left ventricular septal pacing in the remaining 5 patients. Procedure times and fluoroscopy times were prolongued (126 ± 82 min and 27 ± 30 min, respectively). Ventricular lead implant times widely varied ranging from 4 to 115 min, (mean 31 ± 28 min) and the use of multiple delivery sheaths was frequent (50%). The QRS width was reduced from 145 ± 36 ms at baseline to 116 ± 18 ms with CSP. Implant electrical parameters included: CSP pacing threshold 0.95 ± 0.65 V; R wave amplitude 9.2 ± 8.8 mV and pacing impedance 632 ± 183 Ohms, and remained stable at a median follow-up of 478 days (interquartile range: 225-567). Systemic ventricle systolic function and NYHA class (1.50 ± 0.51 vs. 1.10 ± 0.31; p = .008) significantly improved at follow-up. Lead revision was required in one patient at Day 4.
Conclusions: Permanent CSP is safe and feasible in patients with CHD although implant technique is complex.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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